Senior moments: A simple change could have a big impact on your patient's health

One misstep can trigger an older patient's rapid decline. Geriatricians offer advice about attending to the warning signs and tips to prevent a doom spiral.

By Kathleen Phalen Tomaselli, AMNews correspondent. Jan. 3/10, 2005.

Other than passing birthdays, an unwary reflection in a store window or an ever-mounting cache of pills, aging sometimes seems to progress relatively unnoticed. Unnoticed, that is, until something happens -- the onset of a chronic condition, an illness, a fall -- that makes the struggle to maintain health more difficult and requires the patient's system to work harder to compensate.

The challenge of anticipating such occurrences is a critical element to providing preventive care for older populations. In this manner, treating elderly patients requires vigilance, because something as simple as the wrong pair of shoes or a new kind of cold medicine can undermine a patient's delicate equilibrium.

"It's an uneasy balance, and any additional insult can throw the whole thing off," said Joanne G. Schwartzberg, MD, director of aging and community health for the American Medical Association.

By 2030, one in five people will be older than 65. Couple burgeoning numbers with dramatically increased longevity, and there aren't enough geriatricians to take care of aging patients. As a result, primary care doctors will continue to play an important role for this patient population, said Mary Jo Cleveland, MD, a geriatrician and director of the Suma Health Center for Senior Health in Akron, Ohio.

"Primary care physicians can look for correctable or reversible problems," agreed Barney Spivak, MD, director of medical services and geriatric medicine at Waveny Care Center in New Canaan, Conn.