Frequently Asked Questions

1How is Geriatric Medicine different from General Medicine?

Just as how Paediatrics- deals with children and diseases related to the younger population, Geriatrics deals with diseases and medications in the older population.

It differs from Internal Medicine in the focus of the treatment. As people age, they become more heterogeneous, meaning that they become more and more different, sometimes strikingly so, with respect to their health and medical needs. Different organs age at different rates in the same person. Some older people have diseases related to the heart, whereas others may have a poor muscle and bone strength, due to degeneration of the musculoskeletal system. A husband may be actively walking but suffer from memory loss, whereas the wife may be wheelchair bound, but have a clear mind.

2How is treating an older person different compared to a younger person ?

Diseases may show up in older adults in very unusual ways. An older person may not experience the classical chest pain of Myocardial ischemia (commonly known as heart attack). Instead, an older person may have a stomach ache and feel nauseous or simply feel extremely tired. Therefore, the medical history of older patients may not be completely reliable and often a collateral history from other members needs to be considered.

Older patients often have multiple diseases and these may affect the treatment plans for another condition. E.g – A patient with a fracture of the hip may not be able to undergo surgery because of a severe lung condition that may need to be addressed first. She may also have uncontrolled diabetes and blood pressure that needs to be stabilized before they can be taken up for surgery. To complicate decision making, the family members may have differing views on managing a complex problem and there needs to be a transparent discussion among family members and the physician, which is called ‘shared decision making’.

3Why are older people on too many medications? How can they be harmful?

Most of the older patients have many chronic diseases and will be taking more than 7 medicines. Multiple diseases require multiple medicines. However, in an ageing body, the liver and kidneys have a decreased capacity to filter off the harmful substances that accumulate when a drug / medicine enters into the system. This puts an older person at a higher risk of developing medicine related adverse effects. Accordingly, some of the medications need to be given in smaller doses, and some medicines are harmful for the older person and needs to be avoided altogether.

4What is the primary goal of a geriatrician ?

Geriatricians focus on maintaining their functional independence. They use a global approach that encompasses aggressive disease prevention and address the social aspects of illness. The role of the geriatrician, therefore, is to coordinate and guide a team of professionals not only for the clinical management of acute and chronic disease, but also to optimize and maintain functional status, in a concerted effort to keep the patient out of the hospital and living independently and safely at home for as long as possible.