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  1. #1
    Kestrel is offline Platinum level (1000+ posts)
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    Default is getting a geriatric docter helpful?

    is getting a geriatric docter helpful?

    FIL has severe heart issues (multiple bypass operations, pacemaker, defib) and sees a heart specialist. Also has other issues as well. At what point is it helpful to have a geriatric doctor? Do they just take the place of a GP?

    FIL is moving near to us, so leaving all his old Doctors two states away. What's the best transition?

    If it matters, DH is an only child and FIL is 78; I'd be shocked if he's with us more than a year or two. He has private insurance that seems pretty good; I don't know the details.

  2. #2
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    When we moved MIL to our town, the first MD she saw was the geriatrician. Yes, they take the place of a GP. They can point you to a good heart specialist. With elderly people, you actually want to decrease the number of doctors they see and try to make the geri doc the coordinating doc. All reports go to that person, referrals come from them, etc. That helps reduce poly pharmacy. And depending on FIL's health, you may want to limit the number of procedures he goes through. At a certain point--the risk is greater than the benefit. And the geriatrician can help decide what is beneficial and what isn't.

    Does your FIL have a living will? You should get DH appointed as medical power of attorney and overall power of attorney. Have that conversation NOW before there is a crisis. DH and MIL did all the paper work at a lawyer's office.
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  3. #3
    NCGrandma is offline Emerald level (3000+ posts)
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    Quote Originally Posted by StantonHyde View Post
    When we moved MIL to our town, the first MD she saw was the geriatrician. Yes, they take the place of a GP. They can point you to a good heart specialist. With elderly people, you actually want to decrease the number of doctors they see and try to make the geri doc the coordinating doc. All reports go to that person, referrals come from them, etc. That helps reduce poly pharmacy. And depending on FIL's health, you may want to limit the number of procedures he goes through. At a certain point--the risk is greater than the benefit. And the geriatrician can help decide what is beneficial and what isn't.

    Does your FIL have a living will? You should get DH appointed as medical power of attorney and overall power of attorney. Have that conversation NOW before there is a crisis. DH and MIL did all the paper work at a lawyer's office.
    Definitely agree with StantonHyde. A couple of additional things: most geriatricians are either internists or family physicians who have additional fellowship training in geriatrics. They are definitely oriented to coordinating care and especially coordinating meds prescribed by others (and reducing unnecessary meds). They are typically more attuned to which meds are not appropriate for older patients. Also, good geriatricians make referrals based both on which specialists are good but also which of them provide appropriate care for older patients.

    One caveat, though: depending on where you live, it may be hard to find geriatricians, or at least those who are accepting new patients. The last time I looked, most geriatric fellowships had unfilled positions, despite excellent training and decent funding. So the demand keeps increasing, and the supply is certainly not keeping up.

    Unless you know of geriatricians in your area, you may want to contact the closest medical school and see if they can give you any suggestions. Definitely don't wait until you need one.


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  4. #4
    NCGrandma is offline Emerald level (3000+ posts)
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    Quote Originally Posted by Kestrel View Post
    FIL is moving near to us, so leaving all his old Doctors two states away. What's the best transition? .
    One more suggestion: make every effort to ensure that all his medical records come with him. Any person with a complex medical situation can get in trouble if they have problems but no one in their new location has their med record. Also, even if a geriatrician or other new primary care doc in your area may want to make changes in his meds, make sure that he has an adequate supply of meds and refills in the meantime. With national pharmacy chains, it's easier than it used to be to refill meds in a different location, but only if there is refill authorization for enough refills.


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  5. #5
    o_mom is offline Pink Diamond level (15,000+ posts)
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    It depends on the doctor if they replace a PCP. The one we have used here generally does not replace the PCP, but acts as a care coordinator for specialist and will take on treatment of specific geriatric issues such as dementia, mobility, etc. However, you still have a PCP for the routine stuff.
    Mama to three boys ('03, '05, '07)

  6. #6
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    maestramommy is offline Pink Diamond level (15,000+ posts)
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    When we moved my parents here, I went looking for primary care docs that would also help with the Alzheimer's issue. Most people directed me to a primary care practice that specializes in geriatrics. I have to say they have been AWESOME. The doctors and admin staff are some of the most gracious and PATIENT people I've met in ages. They explain all sorts of things you need to know, they took down my name and signature the first appt giving me authority to speak for my parents when necessary, which means if they call to talk about either I can take the call, or I can just call them up if my mom asks me too. This is a big deal because sometimes speaking English for long periods is really exhausting for my mom. Also, all the specialists they connect us to are also used to seeing pretty old patients. My dad is 84 but he's still one of the younger ones. Most of the patients here are in their 90s, with the oldest being over 100.

    We saw the PCP when we needed a handicapped sign for our cars, and will need to see them to get a RX for a wheelchair (since we are trying to get it covered).

    The other thing is that this practice is in the same office as Generations, which is an Alzheimer's dementia care office. Dad saw a psychiatrist to follow up on the meds he was already taking for that, and we see his NP for follow ups, any issues, like when we needed a sleep aid/anti anxiety me.

    This biggest thing is that everything in this area is on computer, and since the PCP keeps us in network, every specialist we see (and there many, between both parents) has all of their records and list of meds at a glance.
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