How does a geriatrician complement the services of other doctors?

Susan Levy, M.D.

“Caring for the elderly is really an interdisciplinary process,” notes my colleague, Debra Wertheimer, M.D., director of the Geriatric Assessment Program at Levindale, and a geriatrician and staff physician at Sinai Hospital of Baltimore. “A geriatrician also will be more familiar with resources available in the community.”

Sometimes people who are 60 or older and do not have any health problems decide to stay with their primary care doctors. Other times, they decide to also work with a geriatrician, so he or she has a baseline to analyze any changes if, or when, they happen.

In addition to primary care physicians, other team members that can help elderly parents and their relatives are social workers, physical therapists, occupational therapists, speech/language therapists, psychiatrists, psychologists, cardiologists, urologists and neurologists.

Geriatricians and geriatric-medicine specialists may offer comprehensive geriatric assessments to have a better idea of the needs their patients are facing. These assessments can take several hours. Have a current list of medications, glasses’ prescription, hearing aid, dentures, and information about previous doctors with you for the assessment. Typically, the assessments begin with a detailed questionnaire, which may also require answers from a family member. The geriatric assessment usual involves:

• A complete physical 
• A comprehensive medical history
• A record of medications and what they are treating
• An analysis of pain levels
• Cognitive testing 
• A screening for osteoporosis
• Vision and hearing tests
• A dental exam
• A dietary consultation
• A social worker evaluation
• A family conference

Results from the assessment can include additional medical care, physical and occupational therapy, psychological treatment, changes in medications, legal and financial matters, and any other pertinent information.

Even if a comprehensive geriatric assessment isn’t warranted, periodic check ups with your physician are important to evaluate your risk for and to identify any health problems in the early stages. They include:

• A check for risk factors and symptoms of diabetes
• A breast exam for women and men
• A Pap smear for women (can be discontinued after 65 if there are no problems with previous screenings).
• A rectal exam for prostate cancer (PSA test) for men
• A skin cancer screening
• A cholesterol screening
• A screening for vision and hearing
• Osteoporosis and fall risk assessments
• A memory and mood screening

Additionally, geriatricians work with family members and caregivers, not only in the nurturing of their loved ones, but in ways to cope with their own anxieties and stress.

Susan Levy, M.D., is the Vice President of Medical Affairs and Medical Director at Levindale Hebrew Geriatric Center and Hospital in Baltimore, Maryland. Dr. Levy graduated from the University of Maryland School of Medicine and did a residency at the Medical University of South Carolina. She completed a geriatric fellowship at Mount Sinai Medical Center. Dr. Levy is board certified and her expertise is in Internal Medicine and Geriatric Medicine. Dr. Levy serves as President of Maryland Medical Directors Association (MMDA) and is an American Medical Directors Association (AMDA) Certified Medical Director (CMD).