What is Geriatrics

Firstly then, what is geriatrics? It's a specialty of medicine that focuses on care of older people. A geriatrician is someone who has completed that training. I'm going to take the liberty of referring to myself as part of that group, although I have not quite finished training. The scope of geriatrics varies from region to region - here in Australia we work at a secondary level, having been referred older patients with problems by other doctors, for example general practitioners (like family practitioners in the U.S.A.) or emergency department or other specialists. Its important to note we don't treat every problem in every older person - if a patient needs surgery or has a specific problem related to a single organ or system another specialist will care for them, perhaps in consultation with a geriatrician. If they have a less complex problem these are better managed by our colleagues in general practice, for reasons I'll get into. There are particular problems of older people that are the focus of geriatrics, well described by Isaacs as the five giants of geriatrics - incontinence, immobility, instability, impaired intellect (confusion delirium and dementia) and the later added iatrogenesis (problems caused by medical treatment itself).

THat's a reasonable summary of the scope of geriatrics, although as time passes some specific areas have become included. Osteoporosis, insomnia, some parts of aged care psychiatry, dementia and others have been incorporated or increasingly shared.

Geriatricians almost always work as part of a team, often consisting of (but not limited to) nurses, physiotherapists, clinical and neuropsychologists, podiatrists, patient carers (professional and friends/relatives) and of course the patient themselves.