Geriatricians are generally family practice or internal medicine doctors that specialises in the care and treatment of older patients, generally those over 65. But many elderly persons already see their GPs or family doctors regularly – so why do they need to see an “old-age” specialist? For many, they may not. They can continue to go to their GP or family doctor for regular checkups and treatments. So when should you see a geriatrician?

There are probably two occasions that you may wish to consult a geriatrician.

• When your condition has deteriorated with age and is causing significant impairment to your normal daily living. Typically, you are in your mid-or-late 70s and are coping with multiple health problems. The combination of these problems that includes both physical and mental health issues (such as dementia) can be debilitating and you would need specialist help to cope. Typical age-related problems include “cardiovascular disease, stroke, confusion and memory problems, Parkinson’s and Alzheimer’s disease, diabetes, hypertension, depression, respiratory problems, osteoporosis, arthritis, chronic pain, mobility issues, incontinence, vision and hearing impairment and trouble with balance and falls”.
• A good time to consult a geriatrician is when caregivers and loved ones feel overly stretched and stressed. With multiple health conditions and likely depression and mood swings, caregivers for the elderly may need the help of someone who specialises in ageing. The geriatrician can help put into context the complexities that the family is facing in caregiving and can offer advice in planning for current and future care.

So what services do geriatrician actually provide? In many cases, they act as the primary care physician for the elderly individual and the primary doctor who knows the elderly’s overall medical history, current conditions, treatments and medication list. The geriatrician can help coordinate the team of healthcare providers that play a role in the care of the elderly patient – including mental health professionals, nurses, social workers, pharmacists and caregivers. The geriatrician ensures that there is a team approach to taking care of the elderly patient – focused on the person as a whole.

In Singapore, there is a current shortage of of specialist or doctors trained in geriatric medicine. According to a study commissioned by Lien Foundation entitled “An uncertain age: Reimagining long term care in the 21st century“, it is quoted as saying there is “a critical shortage of geriatric medical specialists, nurses and trained caregivers” in Singapore. Unfortunately, with increased competition for doctors and nurses in geriatric care from other developed nations like UK or US whose population is also ageing rapidly, this shortage is not likely to get better in the future. However, there is good news. Singapore hospitals like Alexandra Hospital are piloting a new model of care known as “holistic care” whereby “elderly patients with multiple chronic conditions who get admitted to Alexandra Hospital will not have to worry about visiting different doctors and transferring from ward to ward under a new care model.” This model will be a great help to elderly patients when rolled out across the Singapore healthcare landscape. Will keep you posted.