Introduction to geriatrics

With a growing aging population, understanding Geriatrics has become more important than ever. Indeed, Geriatrics, being a vital branch of medicine, focuses on the health and well-being of elderly individuals.
In this introduction to geriatrics, we will explore the basic principles of geriatrics, its importance, and various aspects of geriatric practice.

1. What is Geriatrics?
2. The Principles of Geriatrics
3. The Importance of Geriatric Medicine
4. The Fundamentals of Geriatrics
5. Geriatric Care
6. Geriatric Training
7. Geriatric Diseases
8. Geriatric Treatments
9. The Practice of Geriatric Medicine
10. The Role of the Geriatrician

1. What is Geriatrics?

Geriatrics is a medical specialty dedicated to promoting the health and well-being of older individuals. It focuses on the prevention, diagnosis, and treatment of diseases and disorders related to age.
Geriatrics is not limited to only managing chronic diseases, but it also encompasses a holistic approach to health that takes into account the physical, psychological, social, and environmental aspects of an elderly person’s life.

2. The Principles of Geriatrics:

The principles of geriatrics are based on a comprehensive and multidisciplinary approach to the health and well-being of older people. Here are some of the key principles of geriatrics:

1. Person-centered: Each older person is unique, with their own needs, preferences, and values. Geriatric care should be personalized to meet the individual needs of each person.
2. Multidisciplinary: Geriatric care requires a team of health professionals, including doctors, nurses, social workers, pharmacists, and therapists.
3. Promotion of independence: One of the main objectives of geriatrics is to maintain the independence of older people as much as possible.
4. Prevention: The prevention of diseases and injuries is a key aspect of geriatrics.
5. End-of-life care: Geriatrics also includes end-of-life care, helping older people and their families make informed decisions about palliative care and end-of-life care.

These principles guide the practice of geriatrics and help ensure that older people receive high-quality care that meets their unique needs.

3. The Importance of Geriatric Medicine:

Geriatric medicine is becoming increasingly important as the population ages. Geriatricians play a crucial role in managing healthcare for older people, particularly those with complex health issues.

4. The Fundamentals of Geriatrics:

The fundamentals of geriatrics refer to the basic knowledge and skills that geriatrics professionals must possess, this includes:

1. Understanding of aging: Geriatricians must understand the physiological and psychological changes that accompany aging.
2. Management of chronic diseases: Geriatricians must be able to effectively manage common chronic diseases in older people.
3. Communication skills: Geriatricians must be able to communicate effectively with older people and their families.
4. Care coordination skills: Geriatricians must be able to coordinate care between different health professionals and navigate the health system for the benefit of their patients.
5. End-of-life care skills: Geriatricians must be able to provide end-of-life care and discuss these issues with patients and their families.

5. Geriatric Care:

Geriatric care refers to a comprehensive range of services intended to meet the unique needs of older people. It is typically provided by a multidisciplinary team of health professionals who work together to deliver a holistic approach to health and well-being. Here are some of the types of geriatric care:

1. Medical care: This includes the diagnosis and treatment of age-related diseases and conditions, medication management, and coordination of care with other health professionals.
2. Nursing care: Geriatric nurses can provide a range of care, including medication administration, assistance with daily activities, and monitoring of the patient’s health status.
3. Physical and occupational therapy: These therapies can help older people maintain or improve their mobility and independence, manage pain, and improve their quality of life.
4. Home care: Many geriatric care services can be provided at home, including medical care, nursing care, physical and occupational therapy, and assistance with daily activities.
5. Palliative care: This care is aimed at relieving pain and other uncomfortable symptoms of serious illnesses. It can be provided at any time during the treatment of an illness, not just at the end of life.
6. End-of-life care: These care, often called comfort care, focus on providing pain relief and emotional support to people in the terminal phase.
7. Support services: This might include help navigating the health system, access to community resources, and support for informal caregivers.

Each older person has unique needs, and geriatric care should be personalized to meet these needs. The goal is always to promote the best possible quality of life for each older person.

6. Geriatric Training:

After obtaining their medical degree, doctors who wish to specialize in geriatrics must undergo additional training.
Geriatric training is crucial for health professionals who work with older people. This entails an in-depth understanding of the aging process, including the physiological, psychological, and social changes that accompany aging. Moreover, it involves staying up-to-date on the latest research and best practices in managing chronic diseases, as well as communication and patient-centered care for patients and their families.

7. Geriatric Diseases:

Geriatric diseases are diseases that typically affect older people. They are often the result of the aging process itself, though they can also be exacerbated by other factors such as nutrition, physical activity, and mental health. Here are some examples of common geriatric diseases:

1. Cardiovascular diseases: This includes hypertension, heart failure, angina pectoris, and myocardial infarction. These diseases are often the result of plaque buildup in the arteries, which can reduce blood flow to the heart and other parts of the body.
2. Alzheimer’s disease and other dementias: These diseases affect memory, thinking, and behavior, and can make it difficult for older people to take care of themselves.
3. Osteoporosis: This disease makes bones fragile and more likely to fracture. It is particularly common in women after menopause.
4. Type 2 Diabetes: This disease affects how the body uses glucose (sugar) and is more common in older people.
5. Arthritis: This disease causes inflammation and pain in the joints. Rheumatoid arthritis and osteoarthritis are the most common types in older people.
6. Chronic lung diseases: This includes chronic bronchitis and emphysema, which are often caused by smoking.
7. Cancer: The risk of developing most types of cancer increases with age.
8. Chronic kidney diseases: These diseases affect the kidneys’ ability to filter waste and excess fluid from the blood.
9. Depression and anxiety: These mood disorders are common in older people, often due to loneliness, loss of loved ones, or physical health problems.
10. Vision disorders: This includes cataracts, glaucoma, and macular degeneration, all of which are more common with age.

It’s important to note that although these diseases are more common in older people, they are not inevitable. A healthy lifestyle, including a balanced diet, regular exercise, and regular medical check-ups, can help prevent or manage these conditions.

8. Geriatric Treatments:

Geriatric treatments aim to manage symptoms, improve quality of life, and maintain the independence and dignity of older individuals.

9. The Practice of Geriatric Medicine:

The practice of geriatric medicine involves a comprehensive and multidisciplinary approach. It requires close collaboration among doctors, nurses, social workers, pharmacists, and other healthcare professionals to provide comprehensive and coordinated care.

10. The Role of the Geriatrician:

A geriatrician is a physician who specializes in the health and care of older people. Their role is vast and includes several key aspects:

1. Comprehensive Assessment: Geriatricians evaluate not only medical problems, but also psychological, social, and functional issues. They aim to understand how various diseases and conditions impact their patients’ daily life.
2. Management of Chronic Diseases: Geriatricians are often involved in managing common chronic diseases in older people. These include hypertension, diabetes, arthritis, and heart diseases.
3. Prevention and Management of Disabilities: Geriatricians work to prevent and manage disabilities in older people, helping to maintain independence and quality of life for as long as possible.
4. Management of Polypharmacy: Older people often take multiple medications at the same time, which can lead to drug interactions and side effects. Geriatricians help to minimize prescriptions to reduce risks.
5. Palliative and End-of-life Care: Geriatricians are often involved in palliative and end-of-life care, assisting patients and their families in making informed decisions about care.
6. Care Coordination: Geriatricians often work as a team with other healthcare professionals, such as nurses, social workers, physiotherapists, and pharmacists, to provide comprehensive and coordinated care.
7. Education and Support for Families: Geriatricians also provide education and support to families of older people, helping them understand the challenges of aging and navigate the healthcare system.

In summary, the role of the geriatrician is to assist older individuals in maintaining their independence and quality of life, while managing the medical, psychological, and social challenges of aging.

Conclusion:

Finally, in this introduction to Geriatrics, we can conclude that understanding it requires recognizing, above all, that it’s a complex and rewarding medical discipline playing a crucial role in promoting the health and quality of life of older adults. As our population continues to age, the demand for quality geriatric care will only increase.
As healthcare professionals, we have a responsibility to understand and meet the unique needs of this population. By continuing to learn and adapt, we can ensure that our elders receive the care they deserve.

Dr. Amani Jouini

M.D, Eu Certificate of Competency in Emergency and Disaster Medicine, with five years of experience as an emergency physician and eleven years as a general practitioner in the Department of Internal Medicine and Geriatrics at a university hospital. Devoted to the prevention, diagnosis, and treatment of chronic diseases in the elderly.