Complexities of care: Common components of models of care in geriatrics.

As people age, they are more likely to have an increasing number of medical diagnoses and medications, as well as healthcare providers who care for those conditions. Health professionals caring for older adults understand that medical issues are not the sole factors in the phenomenon of this "care complexity." Socioeconomic, cognitive, functional, and organizational factors play a significant role. Care complexity also affects family caregivers, providers, and healthcare systems and therefore society at large. The American Geriatrics Society (AGS) created a work group to review care to identify the most common components of existing healthcare models that address care complexity in older adults. This article, a product of that work group, defines care complexity in older adults, reviews healthcare models and those most common components within them and identifies potential gaps that require attention to reduce the burden of care complexity in older adults.

When is it the right time to ask for a geriatrician?

Given an aging population coupled with a shortage of people to care for them, it is essential to understand the patient qualities for which geriatric expertise would be most beneficial. For the practicing physician attempting to understand the timing of geriatric-care provision, this article reviews the relevant literature, which suggests geriatric expertise should be considered for the patients who benefit most: any patient aged ≥ 85 years, or adults aged < 85 years with complex multimorbidity, frailty, or other geriatric conditions; disability or dementia; or need for palliative or end-of-life care.