What is Geriatric Care?
Geriatric care is comprehensive healthcare tailored to the unique needs of older adults, typically those aged 65 and above, addressing the complex interplay of multiple chronic conditions, age-related changes, functional limitations, cognitive concerns, and social factors that affect health and wellbeing in later life. While not a separate medical specialty in most primary care practices, geriatric-focused care recognizes that older adults often present differently than younger patients, require medication management that accounts for age-related changes in drug metabolism, face higher risks of certain complications, and benefit from holistic approaches addressing not just disease treatment but also maintenance of function, independence, and quality of life. Geriatric care includes management of multiple chronic diseases, cognitive assessment and dementia screening, fall risk evaluation and prevention, medication review to reduce polypharmacy and inappropriate medications, functional assessment, advance care planning discussions, caregiver support, and coordination with specialists and community resources.
Why is it Important?
Specialized attention to geriatric health concerns is essential because aging brings unique challenges that require different approaches than standard adult care. Older adults typically have multiple chronic conditions simultaneously—hypertension, diabetes, heart disease, arthritis, osteoporosis—that interact with each other and complicate treatment. Medications that are safe for younger adults may cause problems in older adults due to age-related changes in kidney and liver function, increased sensitivity to side effects, and interactions among multiple medications (polypharmacy). Inappropriate medications are a leading cause of hospitalizations in older adults. Cognitive impairment, whether mild cognitive decline or dementia, affects millions of older Americans, impacts medication adherence and self-care, and requires early identification for optimal management and future planning. Falls are a leading cause of injury, hospitalization, loss of independence, and death among seniors—yet many falls are preventable through vision correction, medication adjustments, home safety modifications, and balance/strengthening exercises. Functional decline—losing ability to perform daily activities like bathing, dressing, or managing medications—often indicates underlying health problems requiring attention and triggers needs for support services. Without comprehensive geriatric assessment, these issues may go unrecognized until crises occur. Your primary care provider serves as the coordinator of your care, ensuring all specialists and services work together, helping you maintain independence as long as possible, addressing quality of life and not just longevity, facilitating difficult conversations about future care preferences, and supporting both you and your family caregivers.
What to Expect
Comprehensive geriatric assessment during primary care visits includes review of all chronic medical conditions and medications, ensuring optimal management and identifying potential medication problems like duplications, interactions, or drugs that may no longer be necessary. Your provider will assess cognitive function through screening tools like the Mini-Cog or clock drawing test; if concerns arise, more extensive evaluation determines whether changes represent normal aging, mild cognitive impairment, or dementia, and whether reversible causes (like thyroid problems or vitamin B12 deficiency) are present. Falls risk assessment includes questions about previous falls, evaluation of gait and balance, vision check, blood pressure measurement for orthostatic hypotension, medication review for drugs that increase fall risk, and recommendations for home safety evaluation. Functional assessment asks about your ability to perform activities of daily living (bathing, dressing, toileting, eating, mobility) and instrumental activities of daily living (managing medications, finances, transportation, meal preparation, housework)—identifying limitations allows for interventions and support services. Sensory screening checks vision and hearing, as deficits significantly impact function, cognition, and fall risk. Your provider will ensure you're current on age-appropriate preventive care including vaccinations (flu, pneumonia, shingles, tetanus, COVID-19), cancer screenings (individualized based on overall health and life expectancy), and bone density testing for osteoporosis. Nutrition and weight are assessed, as both unintended weight loss and obesity cause problems in older adults. Depression and social isolation screening is important, as both are common yet often overlooked in seniors. Your provider facilitates advance care planning discussions about your wishes for future medical care should you become unable to speak for yourself, including healthcare proxy designation and advance directives. For patients with serious illnesses, palliative care and hospice options may be discussed when appropriate.
How to Prepare
For geriatric care appointments, especially comprehensive evaluations, consider bringing a family member or trusted friend who can provide additional information about any changes they've observed in your memory, function, or overall health. Create a complete list of all medications including prescription drugs, over-the-counter medications, vitamins, supplements, and herbal products—bring the actual bottles if possible so your provider can verify names, dosages, and how you're actually taking them versus what's prescribed. Note any medications you've stopped taking and why. Document any falls or near-falls in recent months, including circumstances and any injuries. Write down questions or concerns you want to address—if memory is a concern, bringing a written list ensures important topics aren't forgotten during the appointment. Bring a list of all your healthcare providers including specialists you see, as coordination among providers is essential. If you've had recent hospitalizations, emergency room visits, or new specialist evaluations, bring those records. Be prepared to discuss honestly how you're managing at home: Do you need help with any daily activities? Are you taking medications correctly? Can you prepare meals? How is your memory affecting daily life? Are you experiencing loneliness or isolation? These conversations can be difficult but are essential for your provider to connect you with appropriate resources. Bring your healthcare proxy or advance directive documents if you have them, or be prepared to discuss these if you don't. If you use assistive devices like canes, walkers, or hearing aids, bring them to your appointment. Consider whether transportation, medication costs, or other practical issues are creating barriers to following your treatment plans, as your provider may know of resources to help. Finally, think about your goals and priorities for your health care—what matters most to you in terms of maintaining independence, quality of life, and medical treatment preferences?
Have questions about geriatric care? Contact Advanced Cardiovascular Specialists & Primary Care at (203) 334-2100 to schedule your appointment.
