How to Talk Like a Geriatrician, Or at Least Understand What They Are Saying

Like any doctor, geriatricians use lots of specific terms. Below, I explain a few to help you venture into their murky literature and professional articles.

Firstly, geriatrics versus gerontology. Geriatrics is the medical specialty that treats older adults and focuses on clinical care. Gerontology is related but broader and refers to the study of aging—including social, biological, and psychological inquiry.

Geriatricians focus a lot on functional status in older adults, specifically how well a person functions in her environment. It is broken down into:
*Activities of Daily Living (ADLs), or what someone needs to function at the most basic level at home. It includes bathing, dressing, toileting, transferring (from bed to chair, for example), walking (even with the help of a walker or cane), and feeding oneself.
*Instrumental Activities of Daily Living (IADLs), namely the more complicated tasks needed to live on one’s own in the world. It includes taking medicines, transportation, managing money, doing housework, shopping, and using the phone.

Medically geriatricians focus on geriatric syndromes, illnesses that primarily affect elderly and are not part of normal aging.

*Dementia is a term that encompasses multiple brain diseases that lead to progressive loss of normal cognitive function. It is usually slowly progressive and characterized by memory loss. The most common example is Alzheimer’s disease.

*Falls. Older adults fall, and it is often for many reasons. It prompts a detailed evaluation by geriatricians and other members of the care team: occupational and physical therapists, pharmacists and social workers.

*Polypharmacy means being on many medications. This becomes a medical problem in itself that puts someone at higher risk of health problems and falls.

*Incontinence means a loss of control of bladder or bowel function. It’s common, but not necessarily normal.

*Frailty is a complex term and not usefully defined by any one physical measure. It conveys that the person is physically vulnerable and in a state of decline not related to any one medial condition. It is important to recognize because a frail person is more likely to get seriously ill or die, and a thoughtful approach to her care is necessary.

As a first attempt at clarifying some terms, I hope this has been instructive. Tell me more about what you might want to know!


About agannac

Agannac is an internal medicine trained physician, currently doing further training in geriatric medicine. She enjoys working with vulnerable elderly in the health care setting and thinking about ways to improve health care for the most socially and medically complex. She hopes to make innovations from around the world relevant in the US.

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