DOCTORS AND HEALTH CARE FOR OLDER PEOPLE: SOME INFORMATION PROVIDED BY GERIATRICS COURSES

Doctors are becoming aware of their attitudes. They are now being trained that we are not powerless in dealing with disabling chronic disease. Within the past fifteen years the number of medical schools offering courses in geriatrics has grown from a handful to a majority. By 1995 experts estimate that every medical school will offer at least some training in this exciting new field. Here is some of the information that geriatrics courses provide.

Diseases can produce different symptoms in older people than they do in the young.

An interesting example is a heart attack. In younger people its wrenching pain is impossible to miss. But by our seventies the only sign of a heart attack may be mental confusion or indigestion. Earlier, doctors might often have sent an elderly heart attack victim home with antacids. Today’s more geriatrically aware physicians are less likely to make this fatal mistake.

Age does not equal illness.

In geriatrics courses doctors learn that not all older people are sick. In fact, as we grow older we differ more and more from one another physically. Students are taught to view their older patients as individuals, not as bodies aged eighty or ninety-five.

What physical changes are normal and what are pathological.

Geriatric training makes doctors sensitive about labeling the many things that can be helped as just “old age.” They are less likely to over-treat too, reading illness into normal changes or pushing drugs excessively. By learning about studies such as the Baltimore study sponsored by the National Institute on Aging, they get a better sense of when to treat their patients and when not to intervene.

To restore function.

They are also trained in the orientation toward disability I just described: improving eighty-year-old Mrs. Jones’s ability to get around can be as worthwhile a goal as curing her disease. If she can get to the store, she may not have to move. She can continue to live with her husband and will not have the heartbreak of going to a nursing home. Reaching these goals may mean arranging for a physical therapist to come to her home to increase her mobility and strength; knowing about the many gadgets that can make life easier for the disabled; treating the depression that is compounding her physical problems; working with her family; knowing what community services are available to keep people out of nursing homes.

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GENERAL HEALTH