Geriatricians Care For Older Patients

By 2030 there will be only one geriatrician for every 7,665 older adults - unless major steps are taken to recruit and train geriatricians.

By Nancy Giguere, Star Tribune Sales and Marketing

Last update: May 14, 2007 - 10:20 AM

At the beginning of her career, internist Dr. Jennifer Olson worked with a geriatrician. "He encouraged me to visit nursing homes, and I discovered I liked caring for older people," says Olson, a geriatric specialist and medical director of senior services at Park Nicollet Clinic. "Geriatrics demands that you treat the whole person - and that's what I enjoy doing."

Older Patients, Fewer Doctors

Advances in medicine and public health have increased life expectancy from 47 years in 1900 to 77 years in 2001. The number of elders is also increasing: by 2030, the U.S. population aged 65 and over will exceed 70 million - or about twice the number in 2000.

Yet according to a 2005 study by the American Geriatrics Society, by 2030 there will be only one geriatrician for every 7,665 older adults - unless major steps are taken to recruit and train geriatricians.

"In the coming years, geriatricians will be key leaders of change to achieve the goals of improving and maintaining a healthy senior population," says Dr. Meghan Gerety, chair of the board of the American Geriatrics Society. "Geriatricians understand the need to work collaboratively with other professional disciplines to improve the well-being of older persons and help them maintain an independent lifestyle."

Quality Of Life

Geriatricians are concerned with the patient's overall quality of life. That means taking into account not just disease, but also mental health, day-to-day functioning and living environment.

"We treat patients for acute illness, manage chronic diseases like diabetes and provide preventive care. We also screen patients for conditions such as depression and dementia. We assess whether they are able to eat, bath, dress and toilet themselves, manage their medication and prepare their own meals," Olson explains. "And we recommend how they can get help with these activities whether they are living at home, in assisted-living or a nursing home."

Olson likes the challenges of working with these complex patients. She also enjoys getting to know them and hearing their stories. "I love learning about what they've lived through and the life lessons they've learned," she says.

A Good Death

"We need to recognize that everyone dies," Olson says. Every geriatric patient will eventually make the transition from care that "treats everything" to palliative or comfort care.

For example, Olson treated a 96-year-old man who suffered from aortic stenosis, a narrowing of a major heart valve. The only treatment was a valve replacement, which was not feasible for him.

"I told him I could make him more comfortable, but not better," Olson says. The man entered hospice and died peacefully three months later.

A Rewarding Specialty

Geriatric practice offers both variety and flexibility. Olson sees patients in her office, in their homes and in nursing homes. When her four children were growing up, she was able to arrange her schedule so she could attend school events and activities.

Geriatricians also find great satisfaction in their work. In fact, they report the highest job satisfaction of any specialty, according to a 2002 survey published in the Archives of Internal Medicine.

Learn More

The American Geriatrics Society, www.americangeriatrics.org.

Nancy Giguere is a freelance writer from St. Paul who has written about healthcare.

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