Call them good listeners. Call them well-attuned to the needs of older
patients. But, please, just don't call them geriatricians.

That's the word from the founders of TUH's new Senior Care Specialists,
which focuses on the needs of elder patients.

"Often, the word geriatric conjures up images of debilitating disability
and suffering, when what it really means is 'I'm in the latter third of my
life and I want a doctor who understands what that means,'" said John
Cacciamani, MD, Section Chief of Geriatrics at TUH, who will lead the
new practice, which he prefers to describe as "Senior Care."

In fact, Cacciamani says most of his patients don't even know they are
being seen by, gasp, a geriatrician.

"They just think they are being treated by a really good doctor," he said.

Besides Cacciamani, the senior care practice includes two new
physicians who specialize in senior care -- Duane Kirksey, MD, and
B. Brent Simmons, MD -- as well as Donna Nahass, CRNP,
Geriatrics Coordinator for TUH.

The new practice, which was launched July 14, was created for a two-fold
purpose: to better fulfill Temple's commitment to the burgeoning senior
community and to offer medical students a better educational foundation
in working with seniors.

"The Baby Boomers -- all 78 million of them -- are coming through in a
wave," said Cacciamani. "Our community of patients is here, and we are
ready to serve them."

To achieve the gold standard of senior care, it requires a sympathetic
ear and an investment of time. While the average office visit with most
primary care physicians lasts just a few minutes, a typical geriatric consult
can last more than an hour. During this time, the geriatrician will review
a patient's medical history and immediate healthcare needs, but also take
some time to learn about their living environment and support network.

Senior Care is about more than numbers -- i.e., getting your blood

pressure to here or your weight to there, said Cacciamani. It's also about

collaborating with patients on a course of care that will preserve and

optimize their quality of life.

"For example, if you're 50 years old and you show signs of coronary artery

disease, a doctor may instinctively prescribe a statin drug to help lower

your cholesterol," explained Cacciamani. "If you're 90, a senior care

specialist would first consider the possible side effects of statins -- like how

it can affect liver function -- and whether you need to be exposed to that

risk. They may also look at how the drug could interact with your other

medications. Then they'd talk to you about whether you could afford the

new drug. Are you going to have to pay out-of-pocket? Will that mean

you'll have to stop buying one of your other meds? Many other physicians

also think about theses issues but they are our focus; especially when

they impact our patient's functional status or quality of life."

It's also important to understand the numerous diseases and conditions
that commonly affect the elder population, such as arthritis, vision problems,
dementia or incontinence.

 

The greatest lesson one can learn about senior care is empathy, said
Nahass, who, last year, won the Nancy Tatem Award for Excellence in
Geriatric Nursing from the Eastern Pennsylvania Chapter of the Delaware
Valley Geriatrics Society. According to Nahass, clinicians should try to see
themselves through a senior patient's eyes. "A younger patient may have
no trouble following a conversation between a doctor and a nurse who
are discussing their care," she said. "However, if you are hard of hearing,
you might have tremendous difficulty. These are some of the insights we
want to pass on to our students and colleagues."

 

This fall, Temple Senior Care Specialists will go out into the community --
visiting neighborhood events and churches -- to spread the word about its
services in the hopes of making new, lasting connections with patients --
which will be crucial to its success.

 

"We'll serve seniors in two very important ways," explained Cacciamani.
"First, at their doctors' request, we'll perform consults with patients to

evaluate their medical conditions and discuss our findings with each

patient's primary care physician. But we also want to take the

relationship a step further and become the primary care physicians for

senior patients looking for a primary care physician so that we can build

long-tanding relationships and provide continuity of care. It doesn't have

to end at one or two visits. Seniors should think of us as a resource that

can help them navigate through the complex healthcare decisions they'll

face over the next 10 or 20 years."