Time for a Geriatrician?

By Stephen Marcus Finn

Many of us have had to cope with elderly or really old family members who have fallen into decrepitude. They have not been able to meet physical or cognitive demands and were unprepared to move into that new phase of life. The result was that we have had to take on all the responsibility.

And now many of us are reaching that stage, too, and we’re reasonably sure that none of us would want to put that burden on our children or even grandchildren.

So how should we prepare? One way is to visit a geriatrician. Babies and children have needs different from adults; hence, there are medical doctors who specialise in this field: pediatricians. Similarly, older adults have medical concerns different from those they had when they were younger; and here the specialists are geriatricians.

At this stage, my wife, Louis and I, are physically, cognitively and emotionally healthy, still working and working out, still having a hectic cultural life, still travelling a lot, and relishing our family. We realise, however, that this might hit a hiccough, or something more permanent, at some stage, whether it’s in a few months or several decades. We felt we needed a baseline to compare ourselves to ourselves as we get older.

We have been going to a physician annually for over thirty years and, excellent though he is, he is not an expert on those who are not in the first flush of youth, the more mature, the elderly. It’s time for a geriatrician whom we went to a few months ago. She questioned us in detail about our lifestyle (from what we ate to what medications we were on to how we occupied ourselves to whether we lived in a house with stairs or not), looked at our blood results, examined us physically, and tested our cognitive skills with a series of tasks that ranged from memory to vocabulary to arithmetic skills to drawing. She then gave us a frank assessment of our state of being and arranged another appointment for next year.

She will also watch us closely and in the event of either or both of us slipping in any way, we will be able to make plans as to what to do, where to go, how to manage ourselves, before our children have that burden. And that is another important aspect of going to a geriatrician: not to leave the arrangements for care to others; to do it all ourselves while we can. In this way we can be in control of our lives for longer. However, we must all be frank and honest with ourselves about this. Don’t say: “I’ll know when it’s time to move into a retirement home; I’ll know when I should stop driving; I’ll know when I can’t hear that well anymore.” By the time you should know it, you might not be capable of managing it. You might not know anymore what you should know. This is also where geriatricians are important: they will lead you to this realisation in time.

All of us have taken the first important, even vital, step towards planning for our lives as we age by our being part of Chartered Wealth, who have a number of people who are gerontologists, who manage and advise us on our lifestyle and finances.

You might ask what the difference is between a geriatrician and a gerontologist. Gerontologists are professionals who are qualified to work with the elderly; they can be nurses, psychologists, social workers and financial planners. All geriatricians are gerontologists, but not all gerontologists are geriatricians. South Africa has about twenty registered geriatricians in the Western Cape, Gauteng and KwaZulu Natal.

It’s important that we go not only to gerontologists but to geriatricians before our get up and go has got up and gone.

Click here for a list of geriatricians as provided by the South African Geriatrics Society.