It may seem surprising, but as we age, especially once we reach age 75 and older, our bodies require a different approach to medical care than our slightly younger adult counterparts suffering from similar conditions.

That’s because, for people over the age of 75, one symptom can result from a host of causes, said Sinai’s physician-in-chief and noted geriatrician, Steven R. Gambert, M.D. Patients in this age category are termed “frail elderly.”

The problem in caring for the older adult stems from how our bodies react to illness as we age. For most adults, one symptom is generally caused by one medical problem. However, frail elderly patients are more likely to be admitted to the hospital with several simultaneous illnesses—ailments that compound one another.

“Physicians must not be too quick to label a symptom to just one problem,” added Gambert.

Instead, a physician must consider all the factors contributing to an elderly patient’s overall health status. Here is an example:

“The patient may have a disability such as hearing loss and (he or she) may also have muscular atrophy, which will lead to poor balance,” said F. Michael Gloth, III, M.D., a board-certified, fellowship-trained geriatrician (physician who specializes in the care of the elderly). “These disabilities can lead to a fall, which could result in a fracture. This cascade of events is more likely among this population.”

“The elderly have a decreased reserve capacity.

Gloth is the director of Northwest Hospital’s Geriatric Evaluation and Management (GEM) unit, where the care of the frail elderly has been streamlined, their recovery period shortened and their complications upon release reduced.

The GEM unit physicians recognize the reduced ability for frail elderly patients to recover quickly once they get sick.

“The elderly have a decreased reserve capacity,” Gambert said. “Frailty means they are more vulnerable to stress.”

For example, when the frail elderly are hospitalized and put to bed, their decreased muscle mass makes it harder to get out of bed. This, in turn, can lead to a variety of other problems – bedsores, weight loss, dehydration, infection, etc. – ultimately making it harder for patients to recover from the problem that sent them to the hospital in the first place. For the frail elderly, placement in a GEM unit is the most ideal situation.

Physicians at Northwest Hospital’s GEM unit are also available for thorough medical and psychiatric outpatient evaluation of elderly persons. This includes both a pain assessment and depression screening. A multidisciplinary team, including geriatric specialists, pharmacists, social workers, nurses, psychiatrists, and physical and occupational therapists, work with each patient.

“What we’re trying to do is to have the most optimal treatment for the most vulnerable population,” Gloth said of the GEM unit.

For more information about the Northwest Hospital GEM unit vist the web site, or for a physician referral, call 410-601-WELL (9355).

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Northwest Hospital GEM unit