Geriatrics

Geriatrics is a medical specialty focused on the complex needs that emerge when people live with multiple conditions, changing mobility, and shifting priorities about what "good care" means. As humans continue to live longer, there are more health issues that are managed by multiple specialists. Geriatric healthcare professionals see the whole person, not just one organ system at a time.


While most receiving geriatric care are those 75 and over, it's less about age and more about how illness, function, medications, cognition, and social context interact in real life.

What Geriatricians Do — The 5Ms

Geriatricians organize their care around five interconnected domains, the 5Ms, adopted by the American Geriatrics Society. Their work is done in collaboration with primary care, palliative care, social work, and family caregivers to connect home safety, goals of care, and what matters most.

Mind

Dementia, delirium, and depression are common and frequently mistaken for each other. Geriatricians distinguish slow cognitive decline from delirium—a sudden mental status change that is a medical emergency—and conduct formal capacity assessments to determine whether someone can still make their own decisions.

Mobility

Falls are the leading cause of injury-related death in adults over 65—and they are not random. A geriatric team screens for physical risk factors (gait, balance, vision) and environmental ones (lighting, rugs, assistive devices), and assesses activities of daily living to shape decisions about care setting.

Medications

The body processes drugs differently at 80 than at 50. Geriatricians review the full list—prescriptions, OTC drugs, and supplements—and deprescribe what is no longer appropriate or causing harm. The AGS Beers Criteria® (updated 2023) identifies drugs older adults should generally avoid.

Multi-Complexity

Geriatrics was built for the person managing five conditions with six specialists who each see one piece of the picture. Multi-complexity includes social factors—housing, food access, isolation, caregiver availability—and frailty, which changes the risk calculus for surgery and aggressive treatment in ways that age alone cannot.

Matters Most

What does this person actually want? It's critical that what the individual wants is both clearly documented and the guiding force for all medical care decisions. Geriatric teams can help coordinate what matters most to the person, and help create an advance directive, including a DNR order and a POLST form (which medical staff must follow in an emergency). "What matters most" is where geriatrics and palliative care most directly overlap.

Geriatric Care Roles

These are four roles families often run into. For referrals and next steps, talk to a navigator or see the FAQs.

Geriatrician (MD)

Fellowship-trained physician who manages multiple conditions and reviews medications for age-related risks—treating the whole person, not one organ at a time. Fewer than 7,000 board-certified geriatricians serve ~58 million US adults 65+.

When you need them: Multiple chronic conditions, unexplained cognitive or functional decline, or specialists who aren't coordinating.

Geriatric Social Worker

Licensed clinical professional for the emotional, social, and logistical sides of aging—assessments, benefits, family conflict, and transitions. Community-based social workers often provide longer-term support than hospital-only ones.

When you need them: Rushed hospital discharge, family conflict around care decisions, or help navigating Medicare and Medicaid.

Geriatric Pharmacist

Medication safety expert for older adults—bodies process drugs very differently after 75. Reviews full lists for interactions and inappropriate prescriptions. Polypharmacy (five+ meds from non-coordinating doctors) is a leading preventable cause of hospitalization.

When you need them: Five or more medications, unexplained falls or confusion, or no single doctor who owns the full medication picture.

Geriatric Care Manager

Also called an Aging Life Care Professional—a private-pay coordinator (often nurse or social worker) who manages the full care picture, joins appointments, and supports long-distance families. Typically $75–$200/hour; rarely insurance-covered.

When you need them: You live far from your parent, the care situation is too complex to manage alone, or you need a professional advocate inside the medical system.

Loneliness

Loneliness and social isolation are serious health risks. The National Institute on Aging (NIA) and U.S. Surgeon General both treat them as public health priorities. Geriatricians screen for them as part of Multi-Complexity (hearing loss, mobility, bereavement, and retirement).

29%
higher heart disease risk
32%
higher stroke risk
26%
increased dementia risk
~1 in 3
adults 45+ feel lonely

Geriatric Syndromes

Conditions that arise from multiple interacting problems—and are the main reason older adults lose independence or decline after hospitalization.

  • FallsLeading cause of injury-related death in 65+; rarely random
  • DeliriumSudden mental status change; a medical emergency often missed
  • FrailtyDiminished physiological reserve—distinct from simply being old
  • Prescribing CascadesSide effects mistaken for new conditions, prompting more drugs
  • Urinary IncontinenceUnderreported, often treatable; contributes to falls and isolation
  • Sensory ImpairmentHearing/vision loss is a top modifiable dementia risk factor
  • Pressure InjuriesLargely preventable; signal significant systemic risk when present

Frequently Asked Questions

Can I keep my primary care doctor?

Yes. Geriatricians almost always work alongside your existing primary care provider, not instead of them. They typically step in as a consultant or co-manager when complexity increases—and then hand ongoing care back to your primary team.

When does someone need a geriatrician?

Usually when multiple age-related conditions start interacting in ways a single specialist can't untangle—frequent falls, cognitive changes, a growing medication list, or repeated hospitalizations. This often becomes relevant around age 75+, though it depends more on complexity than on a specific birthday.

How can I find a geriatrician?

The American Geriatrics Society maintains a searchable directory of board-certified geriatric healthcare professionals. Search the AGS directory

Do geriatricians work with other care teams?

Yes—geriatrics is deeply collaborative. There's significant overlap with palliative care around holistic, goals-focused care and quality of life. Geriatric teams routinely include social workers, pharmacists, physical and occupational therapists, and chaplains—and connect naturally to caregiving families doing day-to-day support.

Sorting through specialists, facilities, and next steps? We can help you think it through.

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