Older People Need Geriatricians. Where Will They Come From?


That describes Dorothy Lakin, 93, whose recent medical history includes heart failure, macular degeneration, falls, colon cancer and heart valve surgeries, and a stroke.

“She’s had a zillion trips to the E.R., one after another,” said her daughter Mary Ellen Lakin, 70, who lives in Newton, Mass. “I thought, let’s see if there’s a way to make her life easier.”

Mary Ellen Lakin found her way to Dr. Laura Nelson Frain, a geriatrician at Brigham and Women’s Hospital in Boston, who has gently steered mother and daughter through the past year. She reduced the number of medications Dorothy Lakin took and the specialists she saw, stayed in touch with Mary Ellen and sent a geriatric nurse-practitioner to make house calls.

“It’s less of ‘Let’s order this med, let’s order that procedure,’ more of a holistic approach,” Mary Ellen Lakin said. Her mother recently entered hospice care.

Nevertheless, given the numbers, “we’re not going to address this growing older population through some miraculous influx of specialized geriatricians,” Mr. Petriceks said.

Leaders in geriatrics agree, and while they continue working to bolster their numbers, they’re also adopting other strategies. Dr. Mary Tinetti, chief of geriatrics at the Yale School of Medicine, has called for geriatricians to serve as “a small, elite work force” who help train whole institutions in the specifics of care for older adults.

“The most important thing geriatricians can do is make sure all their other colleagues” understand these patients’ needs, she said, including nurse-practitioners, physician assistants, therapists and pharmacists.

Source : Nytimes