FAQ About Aging and Care

1. What is geriatrics?
Geriatric medicine has been defined as the branch of medicine that concerns itself with the aging process; the prevention, diagnosis, and treatment of health care problems in the aged; and the social and economic conditions that affect the health care of the elderly. Arbitrarily, the aged, or elderly, population is defined as persons aged 65 years or older.

2. What is aging?
Aging is a progressive, predictable process that involves the evolution and maturation of living organisms. Aging is inevitable, but the rate of aging varies greatly among individuals. The average life span (or life expectancy) is the age at which 50% of a given population survives, and maximum life span potential is the longest any member of the population lives. The average life span of humans has increased dramatically, yet the maximum life span potential has remained essentially constant, at 90-100 years.

In 1900 life expectancy at birth in the US was 47.3 years; by 1950 it had improved to 68.2 years. In 2000 life expectancy at birth was 73.2 years for males and 80.2 years for females. It is projected that life expectancy will continue to increase, reaching nearly 80 years for men and 86 years for women in 2050.

In the United States nearly 13% of the current population comprises elderly persons. This percentage will increase to 20% by the year 2040. Seniors are the fastest-growing population group in the US, and the population of individuals over 85 is expected to quadruple by 2040. Geriatricians refer to this demographic shift as the "geriatric imperative." For more information on aging in general, contact the Administration of Aging. (www.aoa.dhhs.gov)

3. What's different about older patients?
A frequently asked question by patients involves what is different about elderly persons compared to other adults, in their 30's or 40's. The differences listed below have been part of the impetus behind the creation of the specialty called geriatrics:

• Physiologic changes
• Heterogeneity of health status
• Atypical presentation of diseases
• Increased importance of social support
• Increased prevalence of disease
• Increased incidence of adverse effects of drugs and treatments
• Tendency to have multiple, often interacting, diseases
• Underreporting of symptoms
• Different goals of therapy 

4. What is a geriatrician? 
Geriatricians are physicians who specialize in the care of older adults. A specialist in geriatric medicine has first been certified in either internal medicine or family practice and has had additional experience in caring for elderly people, either by completing additional years of training called a fellowship, or by having extensive clinical experience. In either case, board certification by the XXXXX indicates a physician has passed an examination of his/her knowledge of the specialty of geriatric medicine. Geriatricians are comfortable caring for both the well and sick elderly, but have particular expertise in the very frail patient with multiple complicated illnesses. In addition to the tenets set forth by basic medical training, the geriatric care focuses on the goals of: providing care vs cure; improving or maintaining function and quality of life; prevention; comfort for the terminally ill; coordinating care through an interdisciplinary team process. The two most prominent national organizations representing geriatricians and other health-care professionals involved in the care of the elderly are the American Geriatrics Society (www.americangeriatrics.org) and the Gerontological Society of America (www.geron.org).

5. What does one need to know when choosing a nursing home?
Long-term care decisions are often the most difficult that a person has to deal with, either for oneself or for a family member. Below is a short list of questions to ask yourself when considering a facility. For further information contact various web sites that offer guidance on nursing home selection (e.g., www.nursinghomeinfo.com).

6. Nursing Home Quick Checklist:

• Is the facility clean and free of odor?
• Is it well maintained?
• Do residents look well cared for?
• Are the rooms adequate?
• What recreational and private space is available?
• Are there appropriate safety features, such as railings and grab bars?
• Is the home licensed by their state and certified by Medicaid and Medicare?
• What is the staffing ratio of nurses to residents?
• Do the administrators and professionals have special training in geriatrics or long-term care?
• Are key professionals full-time or part-time?
• How long have administrators and professionals been with the nursing home?
• What type of medical coverage is provided?
• How close is the facility to family members? How close is it to the nearest hospital?
• What is the food like?
• How much do basic services cost? What services are covered?
• What additional services are available and what is their cost?
• What happens if a person runs out of money and needs medical assistance? 

7. What are some symptoms of Alzheimer's disease?
Dr. Alois Alzheimer first described Alzheimer's disease in 1905. AD is a progressive disorder involving deterioration of the brain and resulting in impaired cognition, including memory loss, impaired thinking, and often strange behavior. It is the most common form of dementia and the fourth leading cause of death in adults after heart disease, cancer, and stroke. Visit the Alzheimer's Association web site (www.alz.org) for further information regarding diagnosis, treatment, and support.

8. What are "geriatric syndromes?"
The domain of geriatric medicine often involves the diagnosis, treatment, and management of syndromes common to the elderly population. These include: polypharmacy, dementia, instability and falls, incontinence, iatrogenesis, pressure ulcers, failure to thrive, sensory impairments, and malnutrition. The etiology of these syndromes is usually multifactorial.