Geriatric Assessment
What is a Geriatrician?
Geriatricians are medical doctors who specialise in the health of older adults (65+). They diagnose and treat cognitive disorders, manage falls and balance problems and review medications.
Geriatricians provide a big-picture perspective for people with multiple medical issues. Using a holistic approach, they create personalised, practical care plans for you and your support networks. During your follow-up appointment, your geriatrician will update the plan to suit you.
When to see a geriatrician
Common reasons include:
- Cognitive or behavioural changes
- Mood changes
- Reduced mobility or balance
- Falls or fractures
- Medication review
- Continence problems
- Difficulty with activities of daily living (shopping, driving, cooking, cleaning, personal hygiene)
- Speech, swallowing or nutrition issues
- Recurrent hospitalisations
Conditions we manage beyond diagnosis
Beyond diagnosis, geriatricians are experts in the long-term management of conditions affecting older people. Common examples include:
- Dementia including Alzheimer’s, Vascular, Parkinson’s, Frontotemporal and Mixed dementia
- Frailty
- Incontinence
- Mental health and carer stress
All of the Neurologists at Integrated Neurology have trained in Australian teaching hospitals and are accredited with the Royal Australasian College of Physicians and AHPRA.
What happens at a geriatric consultation?
A consultation with a geriatrician is generally more extensive than a routine appointment with a GP and usually takes 60 minutes. The objective is to obtain a comprehensive account of the person’s symptoms, identify potential causes and establish a plan for investigations and treatments.
1. History Taking
- The geriatrician will ask questions to find out what issues are important to you and how to address them. These usually cover:
- Symptoms: memory or mood changes, falls and mobility, when they started, and what makes them better or worse.
- Medical background: including medications and family history
- Lifestyle factors: sleep, alcohol, exercise and daily routine
2. Examination
- The geriatrician will perform a physical examination. Depending on your symptoms, they may take a blood pressure, listen to your heart and lungs, observe your gait and check your muscle function and reflexes.
- Validated tools for cognition may also be performed.
3. Clinical Impression
Based on your situation, the geriatrician will formulate an initial impression with several possible diagnoses.
4. Further Investigations
- Where appropriate, additional tests may be requested with your priorities. These may include:
- Blood tests e.g. vitamin D, B12, Folate, Iron studies, Thyroid function, Electrolytes, Kidney and Liver function, Full Blood Count.
- Brain Scans (CT, MRI or PET)
- X-rays
5. Management Plan
Ultimately, the geriatrician’s role extends beyond diagnosis of condition to establish a tailored strategy to address your needs. The geriatrician will communicate this plan with you and your GP.
6. Follow Up
A review appointment is important and useful to review the results, the diagnosis and management, and adapt the plan according to what works for you.