Meet the geriatrician

What does a geriatrician do? 

A geriatrician is a doctor who specialises in care for older adults with complex health needs. Rather than looking at just one condition at a time, we look at the whole person. We look at their physical health, memory, mobility, mood, medications, and, most importantly, how they are managing day to day. For someone with Parkinson’s, that joined-up approach can make a real difference. 

Who might be referred to a geriatrician, and when? 

People are usually referred to us when day-to-day life starts to become more of an effort than it used to be. Someone might be having frequent falls, finding it harder to get out and about, or starting to notice changes in their thinking or confidence in doing everyday tasks. Socialising can also become more challenging. 

For people with Parkinson’s, referrals often happen when symptoms progress or when treatments need to be carefully balanced against possible side effects. It’s not simply about age.

How can a geriatrician help me live well with Parkinson's? 

If someone with Parkinson’s is having repeated falls or memory problems, the support they need is rarely limited to one area. 

We often work across different teams and services to help coordinate care. That might involve adjusting medications, linking people with physiotherapy, supporting memory and thinking changes, or helping arrange the right support at home so someone can stay independent for longer. 

Individually these problems can feel manageable, but when they pile on top of each other it can become overwhelming for both the person with Parkinson’s and the people supporting them. 

What issues do you see most often? 

Falls and mobility problems are common, but we also spend a lot of time supporting people with bladder and bowel issues, memory and thinking changes, and planning for the future. 

People are often surprised by how much time we spend talking about bowels in clinic, but it plays a huge role in how Parkinson’s medication is absorbed. It’s also not something that can always be fixed just by prescribing medication. Lifestyle changes can make a big difference too.

Can I ask to be referred to a geriatrician? 

Yes. People can speak to their GP or Parkinson’s nurse if they feel a geriatrician could help them. A GP may refer someone to a geriatrician at diagnosis, or later as their needs change. If someone is being seen by a neurologist, Parkinson’s nurses are often the first to notice when needs are becoming more complex and may suggest involving a geriatrician. 

In some areas, geriatricians also run specialist Parkinson’s clinics alongside neurologists. 

What don't people understand about geriatric care? 

There can sometimes be a feeling that geriatric care means things are getting worse or that it’s an "end of the road" option. But if geriatricians are involved at the right time, we are very well placed to help people remain independent and feel more in control, even as their health changes. 

It’s also important to remember that geriatricians are trained in Parkinson’s care too. Neurologists get trained in Parkinson’s, and so do geriatricians. We may approach things slightly differently, but we are both specialists.

Can you share a moment that has stayed with you?

I remember supporting someone with Parkinson’s who regularly woke up at 3 or 4am during the later stages of their condition. Because we had spent time getting to know them earlier on, we knew they had worked as a milkman and spent years waking up in the early hours. 

Understanding that background helped us approach the situation differently, rather than immediately treating it as a completely new problem. What leaves me touched and humbled is when someone says "We finally feel someone understands what we’re dealing with."

Unless the plan links with what matters to that person, it’s really just a medical plan. It’s not a plan that works for them.