18 September 2009

Isn't it time for you to see a geriatrician?

Geriatrics as one of the most sought-after medical specialties, or facing an elderly patientAlicia Arbakhe, therapist, geriatrician, specialist of the Department of Geriatric Medicine at Johns Hopkins Bayview Medical Center, Associate Professor, answers questions from the editor-in-chief of the newspaper "Medicus Amicus", MD, Prof.

Nikolai Yabluchansky.

When I was studying at the Faculty of Medicine, a venerable and sincerely respected university professor greeted me in an unusual way, repeating at each meeting one phrase: "How are you dying, young man?". I understand that Nature cannot be deceived, with each passing day there is less to live for a day, and in the greeting of the professor, in an unobtrusive form, an offer to take care of life was read. Gerontology, as the science of aging, today also believes that a person cannot live longer than he is allotted by Nature, and if so, what is the role of the geriatrician in modern medical practice?

Geriatrics focuses on promoting a healthy lifestyle, preventing and treating diseases, as well as disability in old age.

Geriatricians specialize in helping elderly people lead as independent a lifestyle as possible (or remain as independent as possible).
The philosophy underlying the care of the elderly is not necessarily to increase life expectancy, but to minimize the time that an elderly person spends in a state of disability and to improve the quality of his life.

There is a debate among experts about what is the natural life expectancy and whether it needs to be increased. The ongoing research aims to understand the genetic and environmental factors that affect life expectancy.

Geriatricians work in different areas of the healthcare system. Some provide care to elderly people in the hospital, others work in rehabilitation centers and nursing homes, and there are also those who visit patients at home.

Some specialists work in specialized groups that lead patients with dementia (senile dementia).

Due to their unique understanding of the healthcare system, many geriatricians hold administrative and managerial positions in government, private medical companies and universities.

Are there any diseases of aging, and if so, what are these diseases and why do they occur?

Undoubtedly, there are so-called "geriatric syndromes" or common diseases inherent in the weak body of elderly people. These are not so much diseases as a group of medical problems that together can create difficulties for the elderly. Geriatricians focus their attention on these syndromes.

Among these syndromes: vision and hearing problems, weakness, dizziness, fainting, bladder problems, walking problems, thinning bones, frequent falls, memory problems and confusion, difficulty swallowing and poor nutrition, as well as problems that relate to the side effects of taking a large number of medications.

When is it necessary to seek help from a geriatrician, and how can he practically help?

While therapists and family doctors guide elderly patients in the USA, geriatricians often consult the most difficult cases (the weakest patients) due to their unique qualifications and training.

In addition to consultations, geriatricians often provide therapeutic care to elderly people with complex medical and social problems. Geriatricians usually collaborate with a group of medical professionals specializing in medical care for the elderly.

Specialists of such a group often work side by side when assessing the condition of an elderly patient.

Such a group may consist of the following specialists: a geriatrician, a nurse, a social worker, a nutrition specialist, a physical therapy doctor, a speech specialist, a psychologist, a pharmacologist, a gerontologist psychiatrist.

The decision on whether to go to a geriatrician is based more on the needs of the patient than on his age. Basically, these are patients over 65 years old, and they are usually over 75 or 80 years old. The following points will help determine if it's time to visit a geriatrician:

• When the patient's health begins to significantly affect his ability to perform daily activities.
• When it is difficult to monitor visits to numerous doctors, tests and medications taken.
• When family and friends feel significant stress while performing caregiving duties.
• When a patient is faced with groups of medical problems that affect the lives of elderly people – “geriatric syndromes".

What is the main thing in providing geriatric care?The main goal of geriatricians is to improve the quality of life of the patient and help him to remain independent for as long as possible.

Geriatricians are convinced that a group of medical specialists is necessary in order to achieve this goal. Geriatricians assess the condition of an elderly patient in the context of many aspects of his life. They include the patient's medical history in the past and present, his emotional state and the possibility of social assistance that can be provided by a spouse, children or friends. They also assess the patient's living conditions and take into account their ability to perform daily activities such as bathing, dressing, eating, driving.

How is the geriatric service organized in the USA and how can a patient get help from a gerontologist?Patients can get a referral to a geriatrician from another doctor who believes that the patient needs a consultation.

In addition, the patient can also contact the geriatrician directly. Geriatric offices can be both private and located in medical centers. The Department of Geriatrics at Johns Hopkins University School of Medicine is located at Johns Hopkins Medical Center. Find more information about this center here.  When preparing for a visit to the geriatrician, the patient is asked to request a medical history from other specialists in advance so that the geriatrician can get acquainted with it in advance.

The patient is also asked to bring a list of specialist doctors to whom he seeks help, a list of medications he takes, including those sold without a doctor's prescription, and dietary supplements.

The patient is advised to bring all medications in their original packaging, if possible. It is also recommended that the patient come to the geriatric examination with people who help care for them or help make medical decisions.

How is the training of geriatricians organized in the USA?

Geriatricians in the USA have a diploma of internist (internal medicine) (3 years of postgraduate specialization) or a family medicine doctor (4 years of postgraduate specialization).

Then they receive additional training in medical care for the elderly. Usually such training takes 1-3 years of sub-specialization. There are approximately 9,000 geriatricians working in the USA.

Despite the fact that this is a large figure compared to other countries, it is not enough to prepare for the growing number of elderly people in the United States. There is a great need for geriatricians.

Are there professional organizations/societies of geriatricians, what is their role?

Founded in 1942, the American Geriatric Society (American Geriatrics Society) is a leading non-profit organization of geriatric specialists whose work is aimed at improving the health, independence and quality of life of all elderly people.

The Society embodies its mission in several ways, including activities in the field of clinical practice, professional education, research, public education and information through the AOG Healthy Aging Foundation (FHA), partnerships with other organizations, etc. The AOG Healthy Aging Foundation is a non-profit organization that was founded in 1999 by the American Society of Geriatricians. Its mission is to create bridges between geriatricians and society, as well as to speak on behalf of the elderly and convey to society their needs, such as: wellness, disease prevention, self-care, independence.
The Foundation promotes initiatives in the field of public education, research and public policy. AOG and the Healthy Aging Foundation are doing everything possible to ensure that reliable and practical information is available to the general public, so that this information is free.

The Foundation's phone number is 1-800-563-4916 – from the USA. Additional information is available on the Foundation's website.

Portal "Eternal youth" http://vechnayamolodost.ru18.09.2009

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