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Geriatric Medicine And Education

May 4, 2008
A branch of medicine that focuses on health issues of the elderly is called Geriatrics. This is not the same as gerontology, which is actually the study of the aging process and how it works. The word is derived from the Greek 'geron' meaning "old man" and the term 'iatros' which means "healer". The idea of this specific branch of medicine was conceived in 1909 by a Dr. Nascher. Dr. Leo Nascher was the former Chief of Clinic in Mount Sinai Hospital in New York City and is considered by some to be the "Father" of geriatric medicine in the United States. "Geriatrics" is also derived from the Sanskrit term 'jara' which also means old.

In the United States a doctor who specializes in geriatric medicine is called a 'geriatrician' and these doctors are board-certified in either, or both, family practice and/or internal medicine. These particular doctors have also gained the additional training needed to get the Certificate of Added Qualifications, or CAQ, in geriatric medicine.

The geriatric practice in the UK is also one with a large history of recognizing all the professions and not just the area of medicine, for their part in improving the well being, and the quality of life, for elderly people. Perhaps one of the most important issues dealt with in geriatrics is the treatment and prevention of delirium, or dementia. This condition causes elderly patients to become confused and the patient may lose the knowledge of his or her identity, the identity of loved ones, etc. The physical health of the patient can rapidly decline as a result of this affliction causing the patient to require long-term health care in a residential facility, such as a 'nursing home'.

The American Association of Medical Colleges, otherwise known as the AAMC, along with the Hartford Foundation, hosted a National Consensus Conference on Competencies in Geriatric Education. This consensus was done to reach an agreement on the minimum required learning needed so that a graduating medical student could be considered competent to care for older patients while they were interns. There are no less than twenty-six competencies in eight sorted medical domains. These domains are medication management; the ability for self-care; cognitive and behavioral disorders; balance and walking disorders; abnormal presentation of disease; hospital care for elderly folk, and health care planning and promotion, and palliative care. The whole list of necessary requirements is available on the Portal of Geriatric Online Education website.

The reaction to prescription drugs and the treatment regimen for older people is a very important topic, one which is related to changing physiology and psychology of aging. Physical changes that come with aging and may alter the absorption, the effectiveness and the side effects of many drugs. These changes can occur in the gastrointestinal system, or even in the distribution of drugs due to changes in body fat and muscle; as well as the body's ability to rid itself of a particular medicine.

Another area of great importance is the possibility of improper usage of medications, and of serious problems which result in dangerous drug interactions, or over-dosage. This is a particular issue for elderly persons experiencing substantial problems of memory loss that occurs with dementia, alzheimers, brain injury, etc. This can make it nearly impossible to adequately monitor and adhere to their own medicine schedule. One such study found that no less than 25% of the participants that were studied admitted to skipping, or forgetting, regular doses or even cutting them in half.
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