Eldercare can seem like a maze for Seniors, family members, and caregivers when they need help. It is difficult to understand the different roles and skills of the people who provide care to seniors. This month Elder Voice describes who does what and who will give you the help you need.
To start with a couple of definitions:
Geriatrics/Geriatric Medicine: The area of medicine that focuses on health, care and disease of older people, generally defined as sixty five and up.
Gerontology: The study of aging and aging processes, including physical, social, psychological, spiritual, and aspects of aging.
The people who care and their roles with seniors:
Geriatrician: A physician who specializes in medical care for older people. Geriatrics is separate area of practice from family medicine, and geriatricians have specialized training in older people. Among other areas, they are experts in identifying and distinguishing between normal aging, and problems in aging. To be seen by a geriatrician, one often needs a referral from one’s family/primary care physician.
Gerontologist: A gerontologist generally has a post graduate degree in gerontology. They are found in a range of settings where knowledge of older people is required and also sometimes are private practitioners as consultants in seniors care.
Professional Geriatric Care Manager: Generally a Social Worker, Occupational Therapist, or Nurse who has specialized in working with older people. Their role varies according to setting. Diamond Geriatrics Geriatric Care Managers are Social Workers and Nurses who provide assessment, counselling, planning, advocacy services; consult on issues of housing and transitions, and implement and co-ordinate (case manage) services to clients.
Occupational Therapists: An OT has post graduate training before being allowed to practice. They function in a number of skill areas. They are experts in adaptive equipment needed for rehabilitation such as wheelchairs. They work with people to regain skills of daily living (ADL and IADL Activities of Daily Living and Instrumental Activities of Daily Living) after illness or stroke, for instance cooking, taking public transit, bathing, and dressing. They often also do swallowing assessments for people who seem to be having trouble swallowing. OT’s are both hospital and community based.
Geriatric Social Workers: Social Workers with work experience and training in working with seniors. They also have training in counselling and in working with families and family systems. Their role in hospitals can include discharge planning, liaising and treating family/collaterally involved people of patients.
Physiotherapists: Physios (or Physical Therapist in the U.S.) specialize in helping with physical rehabilitation and recovery from physical injury or from illness. For instance, in a hospital, the physio will assess deficits and potentials as well as remaining skills and abilities to design the programme that will help someone learn to walk again.
Speech Language Pathologists: SLP’s are involved with seniors in helping them learn to speak again after a stroke or a car accident, or for instance, maintain speech that is being impaired by Parkinson’s Disease. SLP’s are also trained to do swallowing assessments.
Discharge Planners: A discharge planner is a hospital based professional, generally Nurses or Social Workers, who is responsible for the transition out of hospital and back to a person’s home or to rehabilitation, or other housing such as a nursing home. Depending on where someone lives in Canada, they may be only responsible for helping patients access public services; those who wish to engage private help or private supportive housing are responsible for setting up and implementing it on their own.
Dietitians: Hospitals and care facilities have dietitians on their staff and dietitians also work in the community and in private practice. They serve as consultants and educators in nutrition, They recommend diets and dietary supplements monitor nutritional status. As more and more becomes known about the importance of nutrition in aging and health, the role of a dietitian will grow in importance.
Hospitalists: When someone is admitted to hospital they will often be assigned a hospitalist, who will be the main physician to follow them while in hospital in place of one’s family or primary care physician. If a patient is transferred from one ward to another, they may be assigned a new hospitalist.
Palliative Care Team: While not one profession we think it important to include Palliative Care here. The palliative care team generally consists of a combination of nurses, physicians, social workers, pastoral care, and occupational and physiotherapists. They focus on relieving and preventing the pain and suffering that often accompanies disease. Current standards no longer require that someone be within six months of death, have an incurable disease, or not be receiving curative treatment before they are eligible for palliative care intervention. Palliative care services are generally accessed through the public health system.
There are many other professionals who also work with seniors. These include, of course, nurses who work in hospitals, care homes and the community; pastoral care workers who provide spiritual support; music and art therapists.