Why a Geriatrician

Older Patients differ in many ways from the young. Indeed such distinctions underlies the separate existence of geriatrics as a medical specialty. They differ mainly because of diagnostic, therapeutic and social problems. It is very difficult to make an early diagnosis in the elderly, because abnormal symptoms such as weakness or loss of appetite tend to be interpreted by them as symptoms of old age, “which just need to be ignored”. In reality these symptoms may be due to the early onset of disease process such as tuberculosis, diabetes, cancer etc. Because of this attitude, disease may be missed and elders tend to suffer in silence. So practical skill and experience are needed in order to obtain adequate histories in geriatric work.

A typical presentation of illness in the elderly is very common. Presentation may be obscure, misleading or silent. Elder may suffer from heart attack without pain in the chest. They may have stomach ulcers, gall bladder complaints or appendicitis without any abdominal pain. Hence only a specialized physician like a geriatrician can make an accurate and early diagnosis.

Elderly patients often have multiple diseases and sometimes may not even be aware of the presence of the disease. Once people are in their 60s or 70s, they show evidence of several pathological process-some active and others inactive but contributing to the total disability of the patients. Only a geriatric physician can identify the multiple problem and treat patient holistically.

A problem which commonly arises in investigating diseases in the elderly is to identify what is normal and evidence to show that standards set for the younger example, if the laboratory investigations reveal slightly diabetes. So results of the investigation should systematically analysed before arriving at the a conclusion on the nature of the diseases. Treatment of diseases in the elderly is as complicated as the diagnosis. The side effect of drugs rise both with the age and the number of drugs prescribed. This may be due to routine prescription of the adult does to the elderly. This leads to poor excretion and accumulation of drugs with unwanted side effects. Multiple diseases mean multiple prescriptions. This leads to more drug related side effects, interactions and omissions. Sometimes side effects of the drugs may be more than its beneficial effects. It is not necessary to have a “pill for every ill”. Many diseases in old age can be managed by non-drug regiments like diet, exercise, physical therapy and counseling.

In addition, the elders suffer from socio-economical problem like isolation, dependency, poverty etc. These problems will precipitate or aggravate the already existing medical problems. Only Geriatrician can do the total assessment and give appropriate management to improve the quality of life of the Senior Citizens.