Many older patients are prescribed too high a dose or too many drugs. Others mismanage their prescriptions at home because of confusion or poor eyesight. And some medications that are perfectly fine for someone in middle age are harmful to older organs and systems.
"About 17 percent of prescriptions are inappropriate" for seniors, Christmas said.
As a result, prescription drugs can create more illnesses for older patients or lead to more hospitalizations, an increased need for nursing home care and sometimes death.
Geriatrics is relatively new to the medical landscape; many hospitals began offering fellowships in the field only in the late 1960s. Since then, geriatricians have been very much in demand.
According to the Alliance for Aging Research, the United States will need about 36,000 geriatricians by the year 2030. But the Institute of Medicine estimates that there were about 7,120 certified geriatricians in 2007, a number that is expected to barely increase, or even decrease, by 2030.
For geriatricians, seven years of basic medical training are capped with one to three years of a geriatric fellowship, during which they see patients ages 65 and older, many of whom have multiple chronic diseases such as high blood pressure or diabetes. Most geriatricians' patients are older than 80.
Unlike specialists, who focus on specific problems, geriatricians are trained to see the whole of a person whose body is slowing down and working differently than that of someone much younger.
"We try to see the person as a person, not a sick organ or a tumor," said Dr. Thomas Finucane, a geriatrician at the Johns Hopkins Bayview Medical Center for 23 years.
Finucane has been seeing Emily Kropkowski, 87, for about five years, and her daughter, Fran Gustin of Perry Hall, can see the difference.
Gustin said both her parents - her father is now deceased - had a generalist as a primary care physician. But she's happy that her mother switched to Finucane, who has "just been wonderful."
"He's sensitive to the elderly's needs, very patient, especially with [Mom] asking questions five times," Gustin said. "And he's even patient with me. He gets back to me when I e-mail. He puts it in layman's terms for me, so I can understand. It just amazes me."
Finucane has an easy way with his patients.
When Kropkowski struggled to get up on the examining table during a recent visit, she apologized for her slowness. "Getting old," she said.
