Specialty Area: Geriatrics
Description of Specialty: Geriatrics is the care of the older adult patient, in
particular diagnosis and treatment of problems associated with aging. The doctor acts as a
primary care coordinator, but occasionally assists with complicated patients.
1. Diagnosis: Dementia (memory loss)
Questions that should be asked:
- What causes memory loss?
- What medicines are available, are over-the-counter medicines effective or what
homeopathic vitamin medication are helpful?
- What can be done for anxiety and agitation associated with memory loss?
- Are there organizations or others that can help with social/family issues or provide
support?
2. Diagnosis: Urinary Incontinence
Questions that should be asked:
- What tests would be helpful in determining the cause of incontinence?
- What are the side effects of medication used to treat this condition?
- How can I tell if I have an infection?
- What is the goal of my therapy to control or to cure?
3. Diagnosis: Age-associated memory impairment ("normal" memory loss)
Questions that should be asked:
- What makes you believe my memory loss is normal?
- What should my family look for to alert me that my memory loss is becoming abnormal?
- Are there any medicines which can help protect me from serious memory loss and how
effective are they?
4. Diagnosis: Constipation
Questions that should be asked:
- What food should I eat to help promote normal bowel movements?
- What foods should I avoid?
- Are there dangers in over-the-counter remedies?
- What is a normal bowel movement and what are normal bowel habits
5. Diagnosis: Pressure Sore (decubitus ulcer)
Questions that should be asked:
- How did I get this and is my circulation involved?
- Are any of my other diseases involved?
- What should I put or not put on the sore?
- How can I keep from getting more sores or from having a recurrence?
6. Diagnosis: Vertebral Compression Fracture
Questions that should be asked:
- Why did I get this and what risk factor do I have?
- What can I do to prevent more fractures from happening?
- Do I have osteoporosis?
- Should I take calcium and how much?
- What physical tasks can I do and should I restrict certain activities and for how long?
- What medications are available and are they appropriate for me?
7. Diagnosis: Shingles (herpes zoster)
Questions that should be asked:
- How did I get this?
- What can I put on it and what should I avoid?
- How long will it last?
- What can I do to help the pain and itching?
- Can shingles recur and with what frequency?
8. Diagnosis: Weight Loss (unexplained)
Questions that should be asked:
- What foods can I eat to improve my weight and should I see a dietician?
- Are my other diseases making me lose weight?
- Can weight loss be normal with aging and can it help me?
- What should I look for in the future to help determine what may be making me lose
weight?
- How often should I weigh myself?
9. Diagnosis: Depression
Questions that should be asked:
- Should I see a psychiatrist or can you help me?
- What side effects of medication prescribed should I look for and should I stop taking
any of them?
- What can I do to help myself besides taking medication?
- How long will it be before I can expect to feel better?
10. Diagnosis: Agitation/Anxiety associated with Dementia
Questions that should be asked:
- What provokes these symptoms?
- What changes in symptoms can there possibly be some control over?
- What types of medicines help these symptoms?
- What side effects should be monitored?
11. Diagnosis: Dysphagia
Questions that should be asked:
- What can cause trouble swallowing?
- What types of foods can be eaten?
- Would a speech therapist help me and are there tests that would help me?
- Will I need a feeding tube or some other way to get nutrition?
12. Diagnosis: Failure to thrive/generalized decline in health without apparent
cause
Questions that should be asked:
- What symptoms should I look for to make certain we can't find a more specific diagnosis?
- Is it worth trying medicines to improve appetite or to treat atypical presentation of
depression?
- What should our goals be for diagnosis and pursuit of patient comfort?
13. Diagnosis: TIA (Transient Ischemic Attack)
Questions that should be asked:
- What risk factors do I have and why did this happen?
- What medicines are available to keep this from happening again?
- Should I take aspirin?
- What are my chances of having another ministroke or full-blown stroke?
- What exercise or diet would help me?
- What can I do to prevent a recurrence?
14. Diagnosis: Old Age
Questions that should be asked:
- How much longer do you expect I'll live?
- How come other people my age don't have the same problems?
- What can I do to prevent age-related problems of diet?
- Should we discuss advance directions or code states in case I get very ill?
15. Diagnosis: Gait Disorders and Falls
Questions that should be asked:
- What specifically causes me to fall?
- Are there tests we can do to tell us why I fall?
- Should I see a neurologist or a physical therapist?
- Should I use a cane or walker?
- What can I do around the house to help prevent falls?
- Are there exercises I can do to help prevent falls?
Charles Crecelius, M.D. Clinical Instructor, Department of Medicine Washington
University School of Medicine St. Louis, MO