DEAR DOCTOR K: My mother has been going to the same doctor for decades. Now that she is 80, should she switch to a geriatrician?
DEAR READER: There’s a lot to be said for a doctor-patient relationship that has built trust over the years. Switching to a geriatrician may not be a good idea – but consulting a geriatrician could be a very good idea. Geriatricians specialize in the health of older adults.
Geriatricians are especially trained to provide patients with practical advice, suggesting changes to enhance safety, nutrition, function and mobility.
Here’s an example. Not long ago a 90-year-old patient of mine developed metastatic cancer. His life expectancy was no longer than a year without treatment, but there were treatments that offered him a chance for several extra months of life.
He consulted with a geriatrician, who asked the patient questions. How would he feel about the time and travel that would be required to undergo treatment? How bothered would he be by various side effects the treatment might cause? And by symptoms that might be caused by the disease itself, particularly if it was left untreated? The geriatrician didn’t urge any particular course of action; she helped the patient understand the issues.
When he had answered all the questions, the patient decided to forgo treatment. If he were to undergo treatment, he would have to remain in town for several months. He also traded off the side effects of treatment against the extra months of life he might get from treatment.
Geriatricians are also alert to the potential harmful effects of medications. Older adults often have numerous health problems that require multiple medications, and the more medications a person takes, the higher the risk of drug interactions.
So I’d recommend that your mother ask her current doctor, or friends and neighbors, about good geriatricians who practice in your area.