(BPT) - Are you 65 or older? While your primary care doctor may be an internist or general practitioner, have you thought about adding a geriatrician to your health care team?

A geriatrician can act as your health care “quarterback,” helping to ensure you get the specific care you need, as well as coordinating care with specialists.

“Our health needs often change dramatically in our later years,” said Dr. Efrem Castillo, chief medical officer for UnitedHealthcare Medicare & Retirement. “The kind of care you deliver to an older adult is not the same as for a middle-aged person. The physiology of older people is very different from people in other stages of life.”

Those differences are significant enough that the medical community developed a specialty — geriatrics — to address the needs of older adults. Geriatricians are licensed physicians who have completed additional training in managing the care of older people. That training makes geriatricians uniquely suited to help older adults manage the complex demands of their health care needs.
One source of that complexity is chronic conditions. Older adults are significantly more likely than their younger counterparts to have a chronic condition such as hypertension, diabetes and heart disease. In fact, about 80 percent have at least one chronic condition, and 68 percent have two or more.

Given the prevalence of chronic conditions in older adults, they’re also heavier users of prescription medications than younger adults. About 90 percent of adults 65 and older take at least one prescription medication, and 40 percent take five or more prescription drugs.

Juggling multiple chronic conditions can introduce challenges for doctors and patients, with one condition sometimes exacerbating the effects of another. Moreover, treatments for illnesses can sometimes interfere with each other. That means the recommended course of treatment could look different in a patient with one chronic condition when compared to a patient with several.

Establishing the ideal treatment regimen for older adults with multiple chronic conditions can be further complicated by side effects unique to older adults. Some medications can be ineffective or even dangerous for older patients. Common over-the-counter drugs such as the allergy medication Benadryl, for example, have been linked to serious confusion in the elderly. Digoxin, a medication used to treat irregular heartbeat, can be toxic to older people when used at doses sometimes prescribed to younger adults.

Geriatricians are trained to understand how drugs uniquely impact older adults so they can appropriately customize their drug regimen to mitigate the risk of complications.

Decisions about how to customize a patient’s treatment aren’t necessarily black and white, requiring a doctor and patient to carefully balance risks and benefits. For example, some diabetes medicines can cause dizziness, meaning the doctor needs to focus not just on regulating the patient’s blood sugar but also on minimizing the risk of a fall, which is the most common cause of injury for seniors.

“A lot of what geriatricians do is determining which medications are more likely to cause harm than help,” said Castillo. “And the concept of shared decision-making is integral here — asking patients, ‘What trade-offs are you willing to take?’”

Sometimes, the trade-offs are purely medical in nature — weighing the pros and cons of taking a certain medication or undergoing a specific screening, for example. But more often than not, they also involve a person’s overall life goals. How important is it to maximize longevity? Comfort? How about independence? Each person answers those questions differently, and geriatricians are trained to use the answers to guide their treatment recommendations and care plan.

When should you seek out a geriatrician for yourself or a loved one? A significant change in health status could be a trigger for a visit with a geriatrician. But any time an older adult feels his or her care is becoming too complex or needs better coordination, a visit with a geriatrician could help.

Finding a geriatrician

With 10,000 Americans turning 65 every day, the demand for geriatricians continues to grow. And despite a shortage of certified geriatricians as the demand increases, many geriatricians will see a patient on a one-time or as-needed basis and then make recommendations to the patient’s primary care physician.

The American Geriatrics Society offers information about how to find a geriatrician on its website, and many larger hospitals and university medical centers have geriatricians on staff that will see new patients. If you’re enrolled in a Medicare Advantage plan, be sure to confirm whether a geriatrician you want to see is in your plan’s network and if your plan requires you to first get a referral from your primary care physician before a visit with a geriatrician will be covered.

UnitedHealthcare members can get help with those questions. From scheduling your next checkup appointment to helping you find a specialist to getting the treatment you need, it’s easier to get the right care at the right time.

* Check with your health insurance provider or Medicare about whether the cost of this new vaccine is covered under your plan. Whether it’s helping to schedule routine care appointments or checkups, UnitedHealthcare can help you navigate the health care system to get the care you need as soon as you need it.

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plans contract renewal with Medicare.

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(BPT) - Silver screen icon Bette Davis once famously pronounced "getting old ain't for sissies." Caring for yourself or a loved one with age-related health issues is no picnic, either. Of all the health issues you may face as you age, vision problems can be particularly devastating. Yet, a new study reveals that many people still don't understand the leading cause of legal blindness for older Americans - a condition that could seriously affect their quality of life.


Age-related macular degeneration (AMD) is the leading cause of vision loss in Americans aged 60 and older, affecting an estimated 15 million people, according to Macular Degeneration Partnership. Prevent Blindness America estimates that 2 million Americans are living with an advanced form, or end-stage macular degeneration, where central vision is completely blocked in both eyes and that number is expected to increase as the baby boomer cohort ages. Damage to the macula - the part of the retina that perceives color and fine detail - results in the inability to see images in straight-ahead vision, and, therefore, affects a person's ability to read, drive, watch TV, focus on small objects, and even see the faces of family and friends.


Despite the prevalence of macular degeneration - more than 40 percent of older Americans have it or know someone who does - three out of four people don't know it's the leading cause of blindness in people older than 60, according to an awareness survey by Wakefield Research. What's more, 66 percent say they aren't confident they could care for a loved one if he or she developed AMD.


As macular degeneration worsens and vision diminishes, the need for caregiving increases. In fact, more than a third (35 percent) of people who know someone with macular degeneration say they frequently assist the patient, the survey found.


"As their visual acuity decreases, AMD patients may feel the need to ask for help with tasks of daily living, such as shopping, writing checks, or reading menus, hinders their independence," says Dr. Mark Milner, associate clinical professor at Yale University School of Medicine, and the co-founder and co-medical director of the Eye Center of Southern Connecticut and Precision LASIK Group. "This puts them at higher risk of feeling depressed, and makes it critical for patients, their caregivers and their physicians to develop an individualized management plan that incorporates a range of treatment and caregiving strategies."


As the need for care increases, the patient becomes more at risk of developing depression and anxiety, a study in Clinical Ophthalmology found.


Milner offers some tips for people with AMD and their caregivers:


*Make the most of every dialogue with your doctor. Prepare a list of questions to discuss, asking about your specific diagnosis and available treatments

*While there is no cure for AMD, lifestyle changes may help slow its progression. If you smoke, quit. Try to lose weight if you need to, and monitor your blood pressure. Be sure to talk to your doctor about these health concerns, too. Simple changes like adjusting lighting and investing in an e-reader that allows you to enlarge print can also make everyday life easier.

* Have a serious conversation with your doctor and your family about whether it's still safe for you to drive.

* Seek support. You can find low-vision resource centers and AMD awareness groups across the country. Online resources like the new website, AMDAffectsMe.com, sponsored by CentraSight, can offer comprehensive information about how AMD is diagnosed and treated, as well as stories from caregivers assisting their loved ones living with end-stage AMD.
* Research the latest treatments. Medical science is always making progress toward treating incurable conditions like AMD. For example, an FDA-approved and Medicare-eligible surgical device is available for patients today living with the most advanced form of the disease. The implant magnifies images approximately three times their size onto the healthy portion of the retina, enabling patients to discern the object of interest. To learn more about the implant, visit www.CentraSight.com or call 1-877-99-SIGHT.

"As you grow older, it's important to monitor your vision health, since the early and intermediate stages of macular degeneration usually have no symptoms," says Dr. Samuel Masket, a clinical professor at the David Geffen School of Medicine at UCLA. "Only a comprehensive, dilated eye exam can detect AMD. The good news is that preventive and treatment options for patients with macular degeneration have advanced remarkably just in the past 10 years. Now these patients may be able to improve their vision and maintain as much of their independence as possible."