More than 70 million baby boomers – those born between 1946 and 1964 – are alive today. In 2026, the oldest of them are turning 80.
With longer lives often comes more complicated health needs: multiple chronic conditions, long lists of medications, balance problems that can increase the risk of falls, and changes in memory. Many older adults also begin relying more on spouses, children or other family members to help manage medical decisions.
Ideally, health care in later life should go beyond just treating individual diseases and medical conditions. It should aim to help older people maintain health, independence and optimal quality of life for as long as possible.
Doctors and nurse practitioners trained in geriatrics specialize in doing exactly that. As a geriatrician for nearly four decades, I’ve seen how the right care for older people can prevent falls, reduce risk of medication side effects and help patients make medical decisions that reflect their goals and wishes.
The problem? There just aren’t enough of us. Finding a health care provider with expertise in geriatrics can be extraordinarily difficult. But there’s good news: You can use a few simple strategies that geriatricians rely on to have more productive conversations with your or your family member’s doctor.
A whole-person approach to aging
Geriatricians are trained to see the bigger picture of aging. They don’t just treat individual diseases – they also focus on preserving independence, function and safety. That includes addressing memory changes, balance problems, complex medication regimens and the difficult trade-offs that often come with complicated medical decisions.
Morsa Images/E+ via Getty Images
A geriatrician can help patients and their families weigh whether a test or procedure will truly improve their patient’s life. Specialists in geriatrics know that most falls have multiple causes – and that practical steps like reviewing medications or improving home safety can prevent the next one.
They also recognize that in older adults, new symptoms should not be blamed simply on aging. Sometimes they can be due to drug side effects. For example, stopping certain sleep medications can reduce confusion and daytime drowsiness, and limiting or avoiding use of opioids for pain relief can prevent debilitating constipation.
Unfortunately, geriatrics is a specialty with a dearth of providers. Nationally, there are fewer than 12 geriatric physicians and 10 geriatric nurse practitioners per 100,000 older Americans. In many rural areas, there are none. And the shortage is unlikely to improve anytime soon. That’s because medical students and advanced practice nurses rarely choose to specialize in geriatrics, and many medical schools provide no formal training in the care of older adults.
This means most older adults will be cared for by clinicians without specialized geriatric training. But older patients and families can still steer care in the right direction by using a straightforward framework geriatricians follow called the “5Ms.”
A geriatrician’s framework
This mnemonic captures the core principles of optimal geriatric care. The letters stand for mind, mobility, medications, multicomplexity and matters most. The importance of each of these essentials of care for older adults may seem obvious, but it’s amazing how often they are overlooked when doctors without training in geriatrics take care of their older patients. Here’s how you can think about them in speaking with your doctor:
Mind: About 10% of adults age 65 and older have dementia, and another 22% have mild cognitive impairment. If you’ve noticed changes in your memory – forgetting appointments or conversations, forgetting to take medications, struggling with bills or relying more on family for help with tasks you once handled easily – bring it to your doctor’s attention. These concerns don’t always surface unless you mention them. When doctors know about memory problems, they can check for treatable causes, adjust medications or recommend further evaluation and lifestyle changes that may be of benefit.
Mobility: Each year, about a third of older adults report at least one fall, and 1 in 10 suffer a fall-related injury. Make sure to tell your health care provider if you have fallen, feel unsteady when standing or walking, or if you worry about falling. Request advice about how you can improve strength, flexibility and balance to reduce the risk of falls and serious injury.
Medications: Four out of every 10 Americans age 65 and older take five or more different medications every day, and 1 in 10 take 10 or more. Any new symptom in an older person could be due to a drug side effect of their medication. So don’t be afraid to ask whether every medication you are taking is absolutely necessary, or whether a new symptom you are experiencing might be a side effect. If you see multiple health care providers who each prescribe medications to you, ask for a comprehensive review of your medications to make certain that nothing is being missed and all your drugs and dosages are appropriate.
Multicomplexity: About 75% of older adults live with two or more chronic medical conditions. When you are followed by several specialists – who limit their focus to a single disease – your care can become fragmented. That often means long medication lists, frequent tests and recommendations that don’t always fit together. A whole-person approach looks at how everything connects. You and your family can help by asking your primary health care provider to step back and review the full picture – all medications, all specialists and any upcoming tests – and help coordinate a clear, organized plan that is best for you.
Matters most: Asking yourself to pin down what matters most to you is a simple but powerful way to help your doctors understand what to prioritize in thinking through your care. With that information, your doctor can look beyond focusing on any one disease or condition and instead work with you to support your personal goals for a good old age. Maybe it’s being able to walk to the mailbox without falling. Or staying in your own home for as long as possible. Or avoiding medications that make you sleepy or confused. Or staying out of hospitals and emergency rooms. Whatever it is, it’s important to have your health care provider focus on your own priorities.
Aging well is not about having more doctor’s appointments or medical tests, nor is it about taking more medications. It’s about getting the kind of health care that will maintain function, independence and quality of life into old age. You may not be able to find a geriatrician, but you can definitely help your doctor better understand the care that’s right for you or your loved one.
