Longer lives often come with more complicated health needs: multiple chronic conditions, long lists of medications, balance problems that can increase the risk of falls, and changes in memory. Many older adults also begin to rely more on spouses, children, or other family members to help make medical decisions.
Ideally, healthcare in later life should go beyond just treating individual diseases and medical conditions. It should aim to help older people maintain their health, independence and optimal quality of life for as long as possible.
Doctors and nurses trained in geriatrics specialized to do just that. As a geriatrician for nearly four decades, I have seen how proper care for older adults can prevent falls, reduce the risk of side effects from medications, and help patients make medical decisions that reflect their goals and wishes.
The problem? Just there are not enough of us. Finding a healthcare provider with expertise in geriatrics can be extremely difficult. But there’s good news: You can use some simple strategies that geriatricians rely on to have more productive conversations with you or your family member’s doctor.
An integrated approach to aging
Geriatricians are trained to see the bigger picture of aging. They not only treat individual illnesses, but also focus on maintaining independence, function and safety. That includes addressing memory changes, balance problems, complex medication regimens, and the difficult trade-offs that often accompany complex medical decisions.
A geriatrician can help patients and their families weigh whether a test or procedure will truly improve their patient’s life. Specialists in geriatrics know this most falls have multiple causes – and that practical steps such as assessing medications or improving home safety can prevent the next one.
They also recognize that new symptoms in older adults should not be attributed solely to aging. Sometimes they can be due to side effects of medications. For example, stopping certain sleep medications can reduce and limit daytime confusion and drowsiness avoiding the use of opioids for pain relief can prevent debilitating constipation.
Unfortunately, geriatrics is a specialty with a shortage of providers. Nationally there are fewer than 12 geriatric physicians and 10 geriatric nurse specialists per 100,000 older Americans. In many rural areas there are none. And the shortage is unlikely to improve any time soon. That’s because medical students and advanced practice nurses rarely choose to specialize in geriatrics many medical schools do not provide formal training in care for the elderly.
This means that most older adults will be cared for by physicians without specialized geriatric training. But older patients and families can still steer care in the right direction using a simple framework geriatricians follow, the ‘5M’s’.
The framework of a geriatrician
This mnemonic summarizes the core principles of optimal geriatric care. The letters represent mind, mobility, medicine, multi-complexity and most importantly. The importance of each of these essential care points for older adults may seem obvious, but it’s surprising how often they are overlooked when physicians without training in geriatrics care for their older patients. Here’s how to think about it when you talk to your doctor:
Please note: approx 10% of adults aged 65 and over have dementiaand another 22% have mild cognitive impairment. If you have noticed changes in your memory (forgetting appointments or conversations, forgetting to take medications, having difficulty with bills, or becoming more dependent on family for help with tasks that you used to be able to perform easily), bring this to your doctor’s attention. These concerns don’t always surface unless you mention them. When doctors are aware of memory problems, they can check for treatable causes, adjust medications, or recommend further evaluation and lifestyle changes that may be helpful.
Mobility: About one-third of older adults live each year report at least one falland 1 in 10 suffer a fall-related injury. Be sure to let your healthcare provider know if you have a fall, if you feel unsteady while standing or walking, or if you are concerned about falling. Get advice on how to do that improving strength, flexibility and balance to reduce the risk of falls and serious injuries.
Medicine: Four in ten Americans are 65 and older take five or more different medications every dayand 1 in 10 takes 10 or more. Any new symptom in an older person could be due to a drug side effect from their medication. So don’t be afraid to ask if each medication you’re taking is absolutely necessary, or if a new symptom you’re experiencing might be a side effect. If you see multiple healthcare providers all prescribing medications for you, ask for a comprehensive review of your medications to ensure nothing is missed and that all your medications and dosages are appropriate.
Multicomplexity: About 75% of older adults living with two or more chronic medical conditions. When you are followed by multiple specialists – who limit themselves to one disease – your care can become fragmented. This often means long medication lists, frequent tests and recommendations that do not always match. A whole-person approach looks at how everything is connected. You and your family can help by asking your primary care provider to step back and look at the whole picture—all medications, all specialists, and any upcoming tests—and help coordinate a clear, organized plan that works best for you.
Most importantly, asking yourself what is most important to you is a simple but powerful way to help your doctors understand what to prioritize when thinking about your care. With that information, your doctor can look beyond the focus on a particular disease or condition and instead work with you to support your personal goals for a good old age. Maybe it’s being able to walk to the mailbox without falling. Or continue living in your own home for as long as possible. Or avoiding medications that make you drowsy or confused. Or staying away from hospitals and emergency rooms. Whatever it is, it’s important that your healthcare provider focuses on your own priorities.
Aging well isn’t about more doctor appointments or medical tests, nor is it about taking more medications. It’s about getting the kind of health care that maintains function, independence and quality of life into old age. You may not be able to find a geriatrician, but you can certainly help your doctor better understand the care that is right for you or your loved one.
Jerry Gurwitz, UMass Chan Medical School
This article is republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/there-arent-enough-geriatricians-heres-how-older-adults-can-still-get-the-right-care-269789.
Published – Mar 1, 2026 6:29 PM IST
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