1. Geriatricians only treat memory issues and dementia
This is a common misconception. Geriatricians are trained to look at the whole person, not just their memory. In fact, a complete geriatric assessment usually takes up to 90 minutes because it assesses medications, falls, memory, and mood. Yes, geriatricians specialize in memory issues; they also manage polypharmacy (too many medications), falls, end of life care, and many other conditions. Check out the GeriAcademy blog on when to see a geriatrician.
2. If I see a geriatrician, I will lose my primary care provider
Again, this is a common misconception. Geriatricians work both as primary care providers and as specialists. A geriatrician is a physician, either an MD or a DO, who has completed training in Family Medicine or Internal Medicine and obtained additional training in the field of geriatrics. Like any other specialist, patients continue to see their own primary care doctor when they see a geriatrician who functions as a specialist.
3. Geriatricians only take away medications.
A goal of any geriatrician is to reduce pill burden. As you age, the way your body processes medications changes. A medication that worked in the past may not be as effective or even harmful for an older adult. Additionally, there is a 10% chance of a bad outcome for every newly added medication. The risk of bad outcomes increases with the number of medications that an older adult takes. Check out the Geriacademy blog, Am I Taking Too Much Medicine. Some medicines can increase your risk of falling, confusion, dry mouth, and other side effects. This is why geriatricians love to reduce pill burden if possible.
4. I have only fallen twice in 6 months; I don't need to see a geriatrician.
2 falls in 6 months are too many! Check out the GeriAcademy blog on falls. Any fall, no matter how small, can lead to severe injury or even death. Your local geriatrician can look into the cause of your falls, whether it be medications, balance issues, weakness, or even nerve issues. Don't let falls get you down.
5. My family member is 99 and still on the same medication; I should continue it forever, right?
Some medications might not be needed at the extremes of age or at the end of life. For example, younger patients with diabetes should have strict control of their blood sugar. However, tight blood sugar control can be dangerous for an older adult, possibly even deadly due to the risk of developing low blood sugars. Therefore, some medications may need to be changed to prevent medication interactions or bad outcomes. Other times some medicines may need to be stopped.
6. My family member has severe dementia; is it too late to go see a geriatrician?
It is never too late to see a geriatrician! Dementia is not just a diagnosis for the patient; it is a diagnosis for the entire family. Often, geriatricians can offer support and resources that family members were not aware of. Patients with dementia who follow a geriatrician remain at home longer and are less likely to be placed in a nursing facility. Also, seeing a geriatrician can help prepare the family for what comes next.
7. The geriatrician only sees patients in the clinic
False! Some geriatricians see patients in the hospital also! Geriatricians work in the hospital as the hospitalist and consultants. Early geriatric intervention for certain conditions like delirium or hip fractures can improve patient outcomes.
8. Dementia is a normal part of aging
INCORRECT! The old way of thinking is that older people just got "senile" as they age. This was before dementia became a diagnosis. Yes, there might be some slowing of memory as we age, but dementia is not normal! The earlier there is an intervention, the better the outcome can be!
9. I don't need to see a geriatrician for urinary incontinence.
Any female with urinary incontinence should see a geriatrician. This is because urinary incontinence can be the first sign of frailty. Check out the GeriAcademy blog on frailty. Early intervention could mean better quality of life, decrease the risk of developing frailty syndrome and lose independence.
10. My parents/spouse only sleeps about 6 hours a night; is that normal?
Surprisingly yes! As we age, we need less sleep. On average, older people only need six hours of sleep in 24 hours! This includes NAPS! So if your family member is napping most of the day, they will most likely be up all night! It is vital to keep your family member awake during the day.
Check out other blog posts on GeriAcademy, and more myths to come!
This post was written by Dr. Mckenzie Cannon DO. Board Certified in Internal Medicine, current geriatric fellow at Carolinas Health Care System Blueridge in Morganton, North Carolina.