(Courtesy of Englewood Health) Dr. Gross is board certified in family medicine and in geriatric medicine and has been a practicing physician for more than 25 years.

Who are today’s typical geriatric patients?

The specialty of geriatric medicine covers ages 65 to 100 plus. Today, there are people living into their 90s—and living well. In my practice, I may see several patients a day in their 90s who are fully functional and part of the community.

I also have patients in their 60s who come in for an office visit and are concerned that they are getting old. How happy they feel when I say that I have many patients who are 20 or 30 years older than they are. I suggest that they are really not that old, and that they can remain active, and relevant, into their 90s.

What are some reasons for people in their 80s and 90s to have a geriatrician as their primary care provider?

The elderly have their own constellation of syndromes and issues. As geriatricians, we have a greater awareness of, and sensitivity to, the needs of the older person. We understand that older patients frequently have coexisting chronic conditions, see multiple specialists and may be on numerous medications. Each patient has his or her own spectrum of health issues. Geriatricians are specialists in the issues and diseases of aging, and we provide continuity of care for patients with complex conditions.

Here are some of the issues and concerns specific to older people:

• Dementia

A major fear of growing older is the development of dementia or memory loss. A geriatrician can help to distinguish between normal aging and the onset of dementia.

• Driving

Giving up the car keys can feel like a loss of independence. Though some people drive well into their upper years, others must stop driving earlier. It is critically important to determine whether it is safe for you to drive. There are places where people can go for driver evaluations that can help determine the safety of continuing to drive.

• • Falls

A fall is not just a fall; it needs to be evaluated. A fall may represent an underlying medical problem such as loss of muscle strength or gait imbalance. Patients tend to deny or minimize falls, but as geriatricians, we want to address any issues that may cause falling and try to prevent further falls.

• Nutrition

Good nutrition is important throughout your life. Be aware of what you eat, and eat well.

• Exercise

There are many opportunities for older people to exercise these days: senior exercise classes, tai chi and chair yoga, to name just a few. Make the effort and exercise! You will be surprised by how much better you feel after having spent time exercising.

• • Hearing

Hearing loss is common as people age. It’s important to pay attention to hearing issues, especially since older people who don’t hear well can become isolated. Many patients deny their hearing loss, to avoid the use of hearing aids. A hearing aid can not only help you hear better, but can make a difference in your overall quality of life.

• Medications

Medications can play a significant role in some of the problems older people develop. They can interact with other medications and be metabolized differently as the person ages. Over-the-counter medications, as well as herbal supplements, also need to be taken into account, as they can interact with prescribed medication. For example, an older person who has trouble sleeping at night might take sleeping pills. Unfortunately, some medications that “help you sleep” can also contribute to falls. The result of such falls can be fractures and hospitalizations. The benefit of taking these pills must be weighed against the risks.

• • Vaccines

Flu, pneumonia and shingles shots are all very important for older people. It’s important to know what vaccines are out there and to ask your doctor for recommendations on routine immunizations.

• Screenings

Which screening tests are necessary? How often should one be screened? When should you stop having certain medical screenings, such as colonoscopy or mammography? These are among the important issues that arise for older patients. Together, we evaluate when the benefits of the screening outweigh the risk.

• Socialization

Keep active, spend time with other people, step outside of your comfort zone. It’s not enough to stay home, watch TV and do crossword puzzles to keep your mind active. It is important to engage in conversations, interact with others and seek out opportunities for socialization.

• Pets

Pets can be important for older people. Studies have shown that pet owners are often more content. Having to walk a dog can encourage exercise and social interaction, and a relationship with an animal can reduce a person’s feelings of loneliness and isolation.

What is most important?

You can judge a society by how it treats its elders. When people come to our office, we recognize that the person is older, and we keep that in mind. For example, we have special electric exam tables that raise and lower, so a patient can easily reach the table. As geriatricians, we help patients understand—and adjust to—the concept of getting older and dealing with the issues of aging. My intention is to enable all my patients to have the best quality of life possible, no matter what their age.

A personal note?

I was a music major in college. Although I realized I wasn’t going to be a professional musician, I loved playing and learning about music. I have played the piano at our synagogue several times. I am now taking guitar lessons and enjoy practicing and learning new songs. Music reaches us on many levels. It can be soothing, relaxing or energizing, and it evokes a variety of emotions. It speaks to us differently than spoken words.

Best advice?

As we age, we should strive to be active and continue to involve ourselves with family, friends, and community. We all want to have a good quality of life, to function at the highest level possible, and to age gracefully and with health. I believe that geriatricians have a central role in helping people to achieve that goal.

Harvey R. Gross, MD, is a member of Englewood Health Physician Network and the immediate past chief of family medicine at Englewood Hospital.