Variety of factors -- not just age -- can influence the decision

Host Amber Smith: Here's some expert advice from geriatrics chief Dr. Sharon Brangman. When should a person seek care from a geriatrician?

Sharon Brangman, MD: Well, typically, the age of geriatrics is 65 and above, and that was a number that was arbitrarily set a couple of generations ago when people who were 65 had usually done very hard physical jobs and had a lot of injuries and illnesses. But now with the advent of a lot of public health and different jobs and a different kind of medical care, we can postpone that aging process a little bit. And some of those chronic diseases now are happening later on in life so that the majority of patients that a geriatrician sees tend to be people in their 80s and beyond. And these are people who have multiple chronic illnesses. They may have some trouble getting through the day. They may have some memory problems.

Geriatricians are experts in managing the complex long list of medical problems and medicines that a person may have, and then helping the patient and families figure out the best way to get that care, whether it's in your home or in another setting. We really like to have people stay in their own home. We really like people to be at the highest quality of life that they can have in the best setting for them. So we can help families make that determination.

Depending on where you live, geriatricians can be your primary doctor or they can be your specialist. In Syracuse, at Upstate, we are specialists. We work with the primary care doctor, and we help the primary care doctor optimize their care. And then we help the family make decisions about care for that loved one if they need care at home or at a higher level of care.

But we also do other things. You know, older adults accumulate a lot of medications as they get older, and sometimes those medications can cause side effects that can make somebody look sicker or have more medical problems than we anticipated. So we can help work on the long list of medications to make sure they all make sense and they're not interacting with each other. We look at someone's physical function to see what we can do to help support them so that they can maintain as much independence as possible. And, of course we help people who have memory problems to help them also optimize their function for as long as possible.

We work on the principle of a comprehensive geriatric assessment. So we look at the whole person. We look at their past medical history. We look at their current medical problems. We look at their cognitive status, their mood, their medications, and their functional status. And then we help them come up with a comprehensive plan for moving forward. So we don't just make a diagnosis. We actually make a diagnosis and then help them set up a care plan.

And in our office we have a team of social workers who can help families identify resources in the area. And we have a team of nurses who are experts in taking care of older people and can help families walk through some of the issues that might come up where you just need to talk to someone and ask a question. So our practice is really geared toward specifically helping people with chronic illnesses and the aging process where they all kind of come together. Because aging itself is not a disease. It's a natural process that we are all going through.

Host Amber Smith: You've been listening to Dr. Sharon Brangman from Upstate Medical University.