Q:What is Geriatrics?
Ans:Geriatrics refers to specialized medical care for older adults, especially for the senior citizens (elderly people after the age of 60 years) in India.
Q:Why do you need Geriatric Care?
- Life expectancy has increased. Hence, elders aged 60 years and above are increasing in numbers.
- Diseases interact with aging effects and cause old age-related syndromes. Hence, the effects of aging must be considered during the diagnosis and treatment of senior citizens.
Q:Why do you need to go to a “Specialist” for Elderly People?
Ans:A Geriatrician is an elderly care/senior citizen specialist who will:
- Differentiate problems due to pure aging and problems due to diseases.
- Analyze the interaction between different drugs and avoid adverse drug effects.
Q:When to visit the Geriatrician?
- Chronic Metabolic Disorders –
- Treatment of Chronic Metabolic Disorder such as Diabetes Mellitus, Hypothyroidism, Hypertension & Dyslipidemia in elderly people is different and needs special attention with close follow up.
- If you started having diabetes before the age of 60, following are recommended after you cross the age of 60:
- You must regularly review your medicines once in 3 months with any consultant as some diabetic medicines have more side effects after the age of 60, even if they suited you earlier.
- You should do a fundoscopy and neuropathy testing every year after 65 years of age.
- If you have hypertension, you should undergo an electrocardiogram annually as a part of your routine health check-up.
- Delirium – A serious disturbance in mental abilities that results in confused thinking and reduced awareness of surroundings.
- Depression – A mood disorder characterized by loss of interest in activities, causing significant impairment in daily life.
- Dementia – A chronic or persistent disorder of the mental process caused by brain disease or injury and marked by memory disorders, personality changes and impaired reasoning.
- Incontinence – It is the lack of voluntary control over urination or defecation.
- Orthostatic Hypotension – A form of low blood pressure that happens when standing up from sitting or lying down.
- Falls – An event of falling or off something.
- Dizziness – An altered sense of balance and place, possibly described as lightheaded, feeling faint or as if head is spinning.
- Osteoporosis – A condition in which bones become weak and brittle.
- Polypharmacy – It refers to the use of multiple medications in a patient, commonly being on 5 or more medicines.
- Multiple Joint Pain – Painful joints especially during movements.
- Frailty – It is a state of increased vulnerability resulting from aging associated decline in reserve and function across multiple physiological symptoms.
- Failure to thrive – It is a condition which includes weight loss, decreased appetite, poor nutrition, and inactivity.
- Elder Abuse – Causing physical injury, avoiding, or neglecting to provide basic needs & care required, causing mental stress to the elder persons.
Q:How do you know if you have Memory Loss that requires to be examined by a specialist? How to handle it?
Ans:If your answer to any 4 of the following questions is “yes”, then you could have Memory Loss that requires specialist opinion:
- Do you often lose or misplace your keys or spectacles?
- Do you repeatedly ask people “What day is it today?”
- Do you depend completely on a to-do lists to perform your daily activities?
- Do you find it difficult to follow the plot of a movie or tv program?
- Do you often get lost or find it difficult to navigate your way back to your home?
- Take a Memory Assessment Test with us. Based on the test results, the Geriatrician can help with even more personalized solutions for you.
Few tips includes:
- To do some brain exercises, try puzzles and sudoku
- To start maintaining a journal or diary.
- To list out all the tasks, routines & remainders and follow it up.
Q:What is Multiple Join Pain? What should I do if I have it?
Ans:You could have Multiple Joint Pain if your answer to any 2 of the following question is “yes”:
- Do you find it difficult to squat in your toilet or sit on the floor?
- Do you feel pain in your shoulder when wearing your shirt or blouse?
- Do you feel your finger joints get stiff in the morning hours?
- Do you feel that recently your knee or ankle joints are warmer or swollen?
- To know the reason for your pain & treat it more accurately, take a Comprehensive Geriatric Assessment with our Geriatrician.
- Based on the assessment results, the Geriatric Physiotherapist may suggest some joint relaxing exercises, stretching and passive exercises.
- Avoid taking pain killers without seeking doctor’s advice as it may lead to serious harmful side effects in your body.
Q:When do you say that you have Urinary Incontinence? How to manage it?
Ans:If your answer to any 1 of the following questions is “yes” that would indicate, you have poor control over urine/Urinary Incontinence:
- Has the number of your urinal visits increased?
- Do you pass urine while coughing or sneezing?
- Do you feel the need to urinate urgently than before?
- Do you feel a sensation of fullness of bladder immediately after passing urine?
- Do you feel the urge to pass stool along with urine?
- Taking a Urinary Bladder Assessment with the Geriatrician along with a Urine routine.
- A urologist opinion could assist confirming the exact diagnosis.
- Do not shy away from your water intake to avoid going to toilet.
Q:How to manage constipation in elderly?
Ans:An in-depth assessment of your bowel movement is recommended. Geriatricians can also help by suggesting appropriate dietary habits such as high fiber diet, increased water intake & also to increase physical activity for better bowel movement.
Q:Why do I find it difficult to balance myself these days? How can I improve my balance?
Ans:Balance issues deals with unsteady walking and difficulty in walking or sitting up right. If your answer to any 2 of these questions is “yes” for most of the time, then you might have difficulty in balancing and it is recommended to be reviewed by a consultant.
- Do you get the feeling of rotation when you sit up?
- Does the surrounding spin around?
- Do you feel the tendency to fall on one side?
- Do you feel you will faint on standing up?
- Do you have any hearing difficulty?
- Do you have pain in your ears?
- The Geriatrician can help better after taking an in-depth assessment for your balance and gait issues along with the Geriatric Physiotherapist.
- Lifestyle changes like putting railings at hip level in the bathrooms, placing a carpet right under the bed might help avoid falls.
- Start using a walking stick or a cane as required. Do not shy away from using them.
Q:What is a Fall risk assessment?
Ans:Fall is one of the most common reason for injury in the elderly population. It can cause from simple fractures to intracranial injuries. Age itself is not a risk factor but the overall health status of the elderly is associated with risk of fall.
You are recommended undergo a fall risk assessment, if your answer is “yes” to any 1 of the following questions:
- Have you fallen multiple times/repeatedly in the past year?
- Did you feel any chest pain, palpitations, or dizziness before the fall?
- Did you get up on your own after the fall?
- Do you fear that you may fall again?
A fall risk assessment is a multi-disciplinary approach performed by a team of geriatrician, physiotherapist, senior nursing staff, dietician, and occupational therapist.
Q:When do I need a Frailty Screening? What is Comprehensive Geriatric Assessment?
Ans:Frailty is the clinical state of increased vulnerability that weakens the elderly. It leads to the inability to cope with their everyday activities.
Frailty can lead to loss of weight, loss of appetite, desire to participate in social activities and a generalized tiredness.
If your answer to any 1 of these questions is “yes” then you would need to undergo a “Comprehensive Geriatric Assessment” that screens your Frailty level.
- Are you older than 85 years?
- Do you have any health problems that limits your daily activities?
- Do you extensively use a cane or walker?
- Do you need someone’s help to do your regular activities?
Comprehensive Geriatric Assessment is a battery of test done by a specialized multi-disciplinary team to check the Frailty Score of elderly.
After the assessment, a “Home Environment Review” is also recommended which enables the multi-disciplinary team to suggest you multitude of lifestyle changes required to avoid future falls and have a better quality of life by trying to maintain your independence.
Q:Is there any special vaccination for elders?
Ans:As per adult immunization schedule, elderly must take both the pneumococcal and influenza vaccine.
Q:Why is dehydration more common in elderly people?
Ans:The elderly people are prone to drinking less water due to fear of urinary problems thus, they suffer from dehydration and electrolyte imbalance. Indian Council of Medical Research’s Dietary Guidelines recommends drinking atleast 2 liters of water every day.
Q:Does the Geriatrician have any special advice for Parkinson’s disease patients?
Ans:Parkinson’s is a progressive nervous system disorder that affects movement that may lead to a degradation in quality of one’s life. Yet elderly can maintain a good quality of life with multiple aids and orthosis available especially for Parkinson’s disease patients. They should also continue occupational therapy services for further rehabilitation.