“There are many ailments peculiar to the approach of old age which require special medical treatment, or the application of particular measures in which we homeopaths are often rewarded for the timely use of appropriate remedies, and the prompt employment of judicious means by seeing the flickering flame rekindle and valuable life considerably prolonged”
Geriatrics is the branch of medicine that focuses on healthcare of the elderly. It aims to promote health and to prevent and treat diseases and disabilities in older adults.
Geriatrics was separated from internal medicine as a separate entity as pediatrics separated from adult internal medicine and neonatology separated from pediatrics.
Elderly female in residential care home
There is no set age at which patients may be under the care of a geriatrician. Rather, this is determined by a profile of the typical problems that geriatrics focuses on.
The term geriatrics differs from gerontology. This is the study of the ageing process itself. The term comes from the Greek geron meaning “old man” and iatros meaning “healer”. However “Geriatrics” is considered by some as “Medical Gerontology”.
Scope
Differences between adult and geriatric medicine
Geriatrics differs from adult medicine in many respects. The body of an elderly person is substantially different physiologically from that of an adult. Old age is the period of manifestation of decline of the various organ systems in the body. This varies according to various reserves in the organs (e.g. Smokers consume their respiratory system reserve early and rapidly).
Many people cannot differentiate between disease and ageing effects (e.g. renal impairment may be a part of ageing but renal failure is not and urinary incontinence is not a part of normal ageing). Geriatricians aim at treating the disease and decreasing the effect of ageing on the elderly. Years of training and experience (above and beyond basic medical training) go into recognizing the difference between normal ageing and what is actually pathological.
The decline in physiological reserve in organs make the elderly vulnerable disease (as dehydration from a mild gastroenteritis) and liable to have complications from mild problems (Fever in elderly may cause confusion leading to a fall and fracture of neck of femur).
Functional ability, dependence and quality of life issues are of greater concern to geriatricians perhaps than to adult physicians. Treating an elderly person is not like treating an adult. A major difference between geriatrics and adult medicine is that the elderly sometimes cannot make decisions for themselves. The issues of power of attorney, privacy, legal responsibility, advance directives and informed consent must always be considered. Elder’s abuse is also a major concern in this age group. In a sense, geriatricians often have to “treat” the caregivers and sometimes, the family, rather than just the elder.
The elderly have specific issues as regard medications. They are particularly subjected to polypharmacy due to many causes. Some it is because they have multiple medical disorders, or use many herb & OTCs, and some adult physicians just prescribe medications to their specific specialty not reviewing other medications used by the elder. The polypharmacy may result in drug interactions including adverse reactions. Also, drugs are excreted mostly by the kidneys or liver, which may be impaired in the elderly and therefore medication might need to be adjusted.
Presentations of diseases in the elderly may be vague and non-specific or present with delirium. Pneumonia may present with low grade fever, dehydration, confusion. Some elderly may find difficulty expressing their symptoms especially if the disease is active and causing confusion or if they have cognitive impairment. Delirium in the elderly may be caused by anything from constipation to a serious problem like myocardial infarction.
Geriatrics giants and elderly diseases
‘Geriatric giants’ are immobility, instability, incontinence and impaired intellect/memory. Health issues in older adults may also include elderly care, delirium, use of multiple medications, impaired vision and hearing.
Psychology of life
“Youth is not a time of life – it is a state of mind. It is not a matter of ripe cheeks, red lips and supple knees; it is a temper of the will, a quality of the imagination, vigor of the emotions, it is a freshness of the deep spring of life. Youth means a temperamental predominance of courage over timidity, of the appetite for adventure over love of ease. If you do not wish to grow old, quit thinking and acting as if you were ageing. Instead of walking drooped shoulders and with a slow dragging gait, straighten up and put elasticity into your steps.
Work, kindness, love, sympathy, helpfulness, interest, they are the eternal youth essences. These never age, and if you make friends with them, they will act as leaven in your life, enriching your nature, sweetening and ennobling your character and prolonging your youth even to the century mark”.
Causes of illness and early ageing
We are eating foods modified by the use of sprays, dusts and washes and grown with synthetic fertilizers. We are taking synthetic vitamins and our children are being immunized against small pox, diphtheria, pertussis, tetanus, typhoid fever etc. According to all our crude tests, these preparations are all free from any or all disease manifestations. All these things help to increase the life span but are leaving a great number of suppressions with a marked increase of neurosis and accompanying diseases.
Homeopathy
If you are unwell give homeopathy a trial, and it will not disappoint you. It will save you time, trouble and money. Further, it is a fact that in patients with cardio-vascular or heart conditions, hypertension or local disorders, good homeopathic prescribing can prolong lives and keep you working longer and give you more comfort than any other method of treatment. It is again a fact that the people who take homeopathic treatment regularly in life are less likely to develop heart troubles or at least will develop them much later in life.
Ambra Grisea: This is a great remedy for the aged with impairment of all functions, weakness, coldness and numbness, usually of single parts, fingers, arms etc. Thinking is difficult in the morning.
Anacardium Orientale: It is a remedy for those who are exhausted be it after serious illness, sexual excesses or the breaking down processes in old age. The greedy, suspicious, malicious old man can use this remedy for all his physical and mental symptoms. Amelioration through eating is a leading symptom.
Antimonium Tartaricum: In old people who have catarrh of the chest for years when every sharp cold spell in the winter brings on catarrh of the chest with thick white mucus attended with great dysponea . They must sit up and be fanned, cannot lie down, due to difficulty breathing and filling up of the chest. Antimonium tart will ease him over a number of these attacks before he dies. When the expectoration is yellow, Ant Tart will tide him over a good many winters.
Bacillinum: Lungs problems of old people with chronic catarrhal condition and enfeebled pulmonary circulation.
Baryta Carbonica: It is adapted to the aged with mental and physical weakness, mental exhaustion, stupor, groaning, murmuring. Childish behaviour of old people.
Crot. Horridus: Nutritional trouble of old age. It is useful in senile dementia with forgetfulness of figures, names of places. Antipathy to his family; he imagines himself as if surrounded by foes or by hideous animals.
Hyoscyamus: Spasmodic cough in old people at night from continuous tickling in throat as if palate were too long.
Hydrastis: Bronchitis with thick yellow tenacious stringy phlegm in exhausted old people.
Senega: Profuse secretion of mucus in the lungs of old people with loose rattling cough.
Agaricus Muscarious: In old people with indolent circulation; especially for headaches headaches of drunkards.
GENERALS – OLD AGE – old people; in
AMBR. Ammc. Anacardium Ant-c. ant-t. Arg-n. Arnica Arsenicum. AUR. BAR-C. Bar-m. Bryonia. Calc-p.. cann-i.. Carb-an. Carb-v.. Causticum Chamomilla COCA cocc. coff. Colchicum Conium. Fl-ac. Graphites Hydrastis Iodium Irid-met. Iris. KALI-C. kreos. LACH. LYC. Millefolium nat-c. Natrum mur.. nitricum acidum. OP. Ov. Phosphorus. SEC. SEL. Seneg.. Silicea. TEUCR. Veratrum.
GENERALS – OLD AGE – premature
Agn. Ambr.. Aurum Baryta carb. Conium. Cuprum. Fl-ac.. Kali-c.. LACH. SEL. Vip.
GENERALS – OLD AGE – old people; in – bachelors; old
con.
GENERALS – OLD AGE – old people; in – maids; old
bov. cocc. con. lil-t. mag-m. plat.
GENERALS – OLD AGE – old people; in – men; old
bar-c. sabal Selenium
GENERALS – OLD AGE – old people; in – women; old – thin, scrawny
sec.
GENERALS – ALZHEIMER’S DISEASE
alum. cordyc. hell. nux-m. zinc.
GENERALS – PARALYSIS – old people; in
Baryta carb. Conium Kali-c. OP.
GENERALS – WEAKNESS – old people; in
Ambr. BAR-C.. Conium Cur.. Nux-m.. Phosphorus. Selenium Sul-ac.
GENERALS – EMACIATION – old people; in
Ambr. anac. BAR-C. carb-v. chin. chinin-s. Fl-ac. IOD. LYC. nit-ac. op. rhus-t. Secale Selenium Silicea
GENERALS – HEAT – lack of vital heat – old people; in
alum. ambr.
GENERALS – ARTERIOSCLEROSIS – old people; in
bar-c. stroph-h.
GENERALS – TREMBLING – Externally – old people; in
alum. ambr. aur. aven. bar-c. calc. cann-i. cocain. con. kali-c. merc. op. phos. plb. plb-act. sil. stront-c. sulph. zinc.
MIND – OLD people agg.
bar-c.
MIND – CHILDISH behavior – old people; in
BAR-C.
MIND – DEMENTIA – senilis
Ambr. Aur-i. Baryta carb.. Conium Crot. horridus Cuprum
MIND – MENTAL EXERTION – agg. – impossible – old people; in
Ambr.
MIND – INSANITY – old people; in
bell. ign. nat-m. nux-v. sep. sulph.
MIND – SADNESS – old age; in
Aurum.
MIND – FEAR – old; of getting
lach. lyc. marb-w. sep.
MIND – DELIRIUM TREMENS – old emaciated persons, in
OP.
MIND – MOANING – old age, in
Baryta carb.
BLADDER – URINATION – involuntary – night – old people
apoc. benz-ac. kali-p. sec.
PROSTATE GLAND – SWELLING – old people; in
aloe BAR-C. Benz-ac. Conium DIG. ferr-pic. Iodium nux-v. prost. Sabal SEL. Staphysagria sulph.
SKIN – ITCHING – old people; in
alum. arg-n. ars. bar-act. bar-c. con. dol. dulc. fago. fl-ac. kreos. mag-p. merc. Mez. nat-sil. olnd. op. sul-ac. sulph. urt-u.
STOMACH – INDIGESTION – old people
Abies-n. ant-c. ars. Baryta carb. caps. carb-v. chin. Chinin-s. Cicuta fl-ac. Hydrastis juni-c. kali-c. nux-m. nux-v. pop.
HEARING – IMPAIRED – old people
bar-c. Cicuta kali-chl. kali-m. mag-c. merc-d. Petroleum phos.
RECTUM – CONSTIPATION – old people
ambr. Ant-c. Baryta carb. Bryonia Calc-p. Conium. Lachesis lyc. Nux-v. Opium Phosphorus Phytolacca Selenium Sulph.
SLEEP – SLEEPLESSNESS – old people; in
Aconite ars. Baryta carb. carc. op. passi. phos. sulph. SYPH.
VERTIGO – OLD PEOPLE; in
Ambr. arn. Ars-i. Baryta carb. Cuprum RHUS-T. sec. Sin-n.
Blood – ANEURISM, of large arteries
Aconite. Aurum Baryta carb. Bar-m. Belladonna CACT. CALC.. Calen.. Carb-v.. CUPR. Digitalis Ferr-p.. Kali-i. Lachesis. Lycopodium. SPIG. Spongia Sulph. Verat-v.
HEAD – APOPLEXY
BAR-C. Belladonna COCC. CROT-H. Gloninum HYDR-AC.. Ip.. NUX-V.
COUGH – OLD people
Am-c. Ambr. Ammc.. Ant-t. Baryta carb.. Carb-v.. DULC. Psorinum. Seneg.
RESPIRATION – ASTHMATIC – old people; in
Ambr. ARS.. Baryta carb.. Carb-v. Coca Conium Seneg.
RECTUM – DIARRHEA – old people
ANT-C. ant-t. ARS.. Bryonia Carb-v. China. Fl-ac. GAMB. NIT-AC..
Winter and Senility
The climate conditions of winter are highly favorable for the development of all kinds of weakness and tendencies to organic disease, especially of the brain, heart, blood vessels, kidneys, and liver. Defects in these organs manifest themselves most frequently and severely in cold weather. The whole constitution is lowered by the conditions of winter, and, to an extent devitalized. The aged must be helped by the provision of heating apparatuses.
GENERALS – HEAT – lack of vital heat – old people; in
alum. ambr.
GENERALS – HEAT – lack of vital heat – operation; from
stront-c.
GENERALS – HEAT – lack of vital heat – pain; during
agar. alum-sil. ars. caust. dulc. led. mosch. sil.
Note: The abbreviations of remedies are the standard ones as found in the standard repertories.
References: From Wikipedia the Free Encyclopedia.
Various Standard Homeopathic Materia Medicas and Therapeutic books.
Synthetic Repertory RADAR 10.31.
excellent article and I congratulate the author. When should one consider oneself old, at 70 ,75,90 or beyond ?
much needed, given that care for the elderly seems almost on the wane!
Good,informative at a time when realization on geriatrics is growing.
Thanks doctor.
Excellent approach. I lot of possibilities in homeopathy
Have been successfully using Phos Ac, both high and low potency in the
case of an 85 yr old female with extreme muscle weakness and failure to
thrive following an unknown infection.
DEAR DR,
IT IS REALLY REMARKABLE THAT AFTER A GREAT SEARCH , HE HAS GIVEN A LIST OF RUBRICS FOR OLD AGE PROBLEMS. HIS GERIATRICS KNOWLEDGE IS GREAT. IT WOULD HAVE BEEN VERY USEFULL IF HE COULD GIVE US SOME CASES TREATED BY HIM. IN OLD AGE OF COURSE THERE ARE MANY PROBLEMS AND GREATEST OF ALL IS KNEE JOINT PAIN FOR WHICH HE HAS NOT MENTIONED ANY REMEDY. FREE OF ALL JOINTS PAIN AND NOT TO HAVE TROUBLE IN OLD AGE I WOULD ADVISE PERSONS ABOVE 40 YEARS TO MOVE 5 TO 10 TIMES EVERY JOINT IN THE SERIAL ORDER. FIRST FINGERS, THEN WRIST, THEN ELBOW, THEN SHOULDER OF BOTH HANDS IN/OUT AND FOLDING/UNFOLDING AND REVOLVING MANNERS. NEXT COME TO DOWN JOINTS OF LEGS FIRST TOE FINGERS, THEN HEAL, THEN FEET, THEN KNEE, THEN THIGHS AND THEN NECK ALL IN THE MANNER STATED ABOVE. THESE EXERCIZES WILL KEEP HIM/HER JOINTS FREE FROM OLDAGE TROUBLES
THANKS
DR SHEKHAR
I never had heard the term geriatrics before this article. You also give some remedies. Thank you for such a good article.
Along with homeopathic treatment, appropriate fruit and vegetable diet are very useful for the old age diseases. Eric Powell in his “Group Remedy Prescriber” has suggested a mixture of remedies for common geriatric problems.[ I have mentioned this although I am not confident with such mixture]. Thiosinaminum as a remedy for retarding old age should be studied in W. Boericke’s M.M. Hypothermia is a common problem and that is why old people suffer much during the winter.
Now, I want to mention a clinical case of urinary incontinence of my ex-colleague aged 65. During the last winter, his trouble [ with nightly aggravation] was maximum. Some so-called specific remedies failed. Next, I gave him a dose of Alumina 10M on the basis of generalities. This dose cured his complaint very soon, and he reported that he felt a better healthy state. Slowness and paresis with regard to feeling, understanding and responding as well as sensitiveness to cold atmosphere in an old person led me towards Alumina. I noted that exposure to cold atmosphere caused nervous debility of the patient in stead of colds, coryza etc .So in that sense, he was a dry patient.
I APPRECIATE IF YOU PUBLISH MATERIAL ON GERIATRIC ARTHRITIS AND ALLIED ORTHOPEDIC PROBLEMS. THANK YOU FOR YOUR CORRECT DEFINITION OF GERIATRICS.I AM SURE ALL THE AGED ARE INDEBTED AND OBLIGED TO YOU.