Attending to crucial ageing needs
MANY people do not know much about geriatrics, says Dr Lam Ngee Wei, consultant physician and geriatrician at Subang Jaya Medical Centre. “The public and even a few people in the medical industry think that geriatricians are general practitioners (GPS) who treat elderly people, as opposed to geriatrics being a legitimate subspecialisation,” he says.
These misconceptions affect the way patients seek treatment, as they do not think a visit to a geriatrician is necessary. Dr Lam explains that geriatricians are trained with advanced knowledge in the healthcare of the elderly. Geriatricians analyse the physical, physiological, social and emotional challenges of the elderly patient and determine if these issues are caused by the natural ageing process, multiple medical conditions and cultural or social influence.
Dr Lam illustrates the differences between a geriatrician and a GP, saying, “GPS will treat an illness and discharge you when you are well. Geriatricians will look into why the illness occurs and if there are any underlying causes to the illness. For example, geriatricians will not just give a patient with pneumonia antibiotics. Geriatricians will check if the patient has had problems swallowing or bad dental hygiene as these factors could be causing the pneumonia, and we will provide vaccinations after treatment to prevent its reoccurrence.”
He emphasises that the elderly do not recover as easily as younger people do, and thus require a more cautious approach during treatment.
Not just a simple cold
It is common for people to not go to the doctor for mild symptoms or illnesses, but Dr Lam discourages elderly people from doing the same. He explains that older people respond to illness differently because of ageing and sometimes, mild symptoms can signify something more serious.
Dr Lam suggests that associating symptoms with normal signs of ageing plays a role in patients’ reluctance to visit a geriatrician. This is because people do not see the need to send their parents or themselves to a geriatrician for check-ups. However, ignoring these issues may cause complications in the long run.
He says, “Prevention is better than cure. Don’t wait for the elderly to fall, become weak, lose weight or become frail because of lack of treatment and
intervention. If patients go to the hospital early, geriatricians can anticipate, target and treat the condition so patients can stay healthy and independent for longer. It may be too late if you wait for something to happen before going to the hospital.”
For patients who may be considering a first visit to a geriatrician, Dr Lam advises that the patients bring along all the medication they may be on, as well as past health reports and their main carers or guardians.
He assures that there is no need for any additional preparation to an appointment. “Geriatricians will carry out a comprehensive geriatric assessment on your medical illness, medication, daily activity, social support, mood and more. They can draw conclusions and help you come up with a healthy ageing plan for you. Geriatricians work very closely in a team with professionals of other specialties and allied health staff to coordinate and provide the care you need accordingly.”
At the end of the day, for older people who are required to meet with multiple specialists for their multiple medical conditions, the burden falls on the carer, commonly the children, to send them for appointments. Hence, it can be overwhelming for those who care for ageing parents.
Dr Lam says geriatricians are designed to help with this issue. “Geriatricians will coordinate the patients’ medical appointments, prescribe medication and monitor their overall medical conditions so they do not have to see so many specialists when it is not necessary.” With that, Malaysian elders and their loved ones will have fewer things to worry about while ensuring their health and quality of life.