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Geriatric Counseling

14 December 2023

Although at present, older adults aged 65 and over lead active lives, work, and engage in a full lifestyle, their physical bodies undergo aging; therefore, even a minor illness may result in a sudden decline in health. If there is any change to the functional or cognitive condition, it is recommended to refer to a geriatric specialist’s counseling and, occasionally, to comprehensive counseling of a multidisciplinary team. It is noteworthy that identifying diseases or specific conditions early on can aid in preventing further deterioration and preserving optimal functioning.

While older age is traditionally defined as 65 years and older in today's world, it is an age group where older adults remain active, engage in social activities, and go on trips in Israel and around the world.

Simultaneously, the body undergoes natural aging processes, which lead to a decline in reserves. Consequently, a sudden and dramatic deterioration may occur after a minor illness, such as a respiratory or urinary infectious disease. Therefore, if you notice a change or decline in your functional, cognitive, or mental condition, or have concerns about dementia, it is recommended to seek advice from a geriatric medical counselor to help in early detection and medical intervention to maintain proper functioning and prevent any further functional deterioration.

Occasionally, your family doctor may recommend a geriatric medical counseling, or a cognitive diagnosis by a neurology or psychiatry specialist (currently, there is no recognized psychogeriatric specialty in Israel).

Geriatrician (geriatric specialist)

A geriatrician is a medical doctor who completed geriatric specialty training and received a degree as a geriatric specialist. As part of their job, they undergo a four-year direct specialization internship, and/or two years of fellowship. After completing their training, they are required to pass a state licensing exam. The geriatricians specialize in diseases and conditions typical of older adults (ages 65 and older). These conditions include cognitive decline, such as dementia, as well as a decrease in memory and comprehension. Additionally, there is also a decline in independent physical functioning, as well as falls and a range of other diseases, with the most commonly occurring being heart disease and strokes.

The geriatricians’ main role is to see the older adults in their entirety and help them achieve the most optimal lifestyle possible, while they are coping with the diseases and conditions that come with advanced age.

Geriatricians usually work with family doctors who provide ongoing care to their patients, and they consult with each other regarding common age-related conditions, such as sphincter incontinence and various chronic illnesses.

Comprehensive geriatric assessment

This service is provided either in a clinic for comprehensive geriatric assessment or a clinic for geriatric consultation, which may refer patients to complete the tests at the HMO. This service is mainly intended for the following audiences:

  • Older adults who have been identified by their family doctor as being at a high risk for deterioration of health and functioning
  • Older adults who suffer from undiagnosed or untreated geriatric conditions, such as recurrent falls or a new and unexplained functional decline
  • Older adults who regularly take six or more medications
  • Older adults who experience frequent hospital admissions
  • Older adults who suffer from morbidity which requires multiple referrals to medical specialists

The Comprehensive geriatric assessment is performed by a multidisciplinary team. A medical doctor who specializes in geriatrics leads the team conducting the comprehensive geriatric assessment. In addition to the doctor, the team consists of a registered nurse (graduate of an advanced nursing course in geriatrics), a social worker (specializing in the field of old age), and additional healthcare professionals, such as physiotherapists, occupational therapists, speech therapists, dieticians, medical professionals from other fields, clinical pharmacists, etc.

The initial step of the comprehensive geriatric assessment involves diagnosing and providing an overview of the patient’s medical condition, as well as an inquiry about the medications and nutritional supplements they are taking to rule out any potential medication interactions that may trigger one of the conditions they suffer. The assessment also includes an overview of the patients’ personal nutritional condition, a cognitive assessment (particularly memory and comprehension), as well as their overall physical and functional capabilities in daily life.

The team assessing the patients will also observe the patients’ social and mental condition, as these factors significantly impact their overall functional status. Additionally, if required, the team may recommend that a specialized group inspect the patient's home to assess whether the home environment is suitable for their needs.

Patients who have undergone a comprehensive geriatric assessment, including a thorough examination of their condition, have exhibited improved functionality, fewer medical visits, fewer falls, and injuries, and have required fewer admissions to nursing institutions.

For meeting the multidisciplinary team, you will be asked to arrive with all the relevant documents and referrals, which will assist the medical professionals in providing an accurate assessment of your condition and tailoring the best solutions for improving your quality of life.
You should prepare in advance:

  • A medical summary from your family doctor, including the complete medical information necessary for your medical condition and the medications you are currently taking. Please note that this summary should be provided in addition to the family doctor's referral (previously known as Form 17)
  • Updated lab, blood, and urinal tests, according to the assessment schedule
  • Additional tests according to the family doctor’s recommendations, such as echocardiography
  • If you have undergone a geriatric assessment in the past, please bring it with you

It is recommended that a family member who knows the patient well be present during the geriatric assessment.

According to all the information gathered by the multidisciplinary team, the patient will receive recommendations about necessary tests and treatments to commence, and medications to start or discontinue.

These recommendations are sent to the family doctor as well. Implementing the recommendations can help improve the patient’s functionality and promote their quality of life.

Geriatric counselling and comprehensive geriatric assessment are part of the health basket services and fall under the responsibility of the HMOs. The family doctor can provide a referral for geriatric counselling and a comprehensive geriatric assessment.

Each one of the HMOs offers a range of services in the field of geriatrics, including virtual geriatric counselling, in which patients can consult a geriatric medical specialist through video consultation and receive a summary of the session along with prescriptions, etc. You can check with your HMO which geriatric counselling and assessment they provide.

Private consultation can also be provided, or it can be covered by private insurance (if you have one).

HMO Inquiries

Useful information

Useful information

Occasionally, a geriatrician or physician assessment may be necessary to be eligible for social benefits, such as receiving a long-term care allowance from the National Insurance according to the Nursing Act or obtaining a license to employ a foreign worker.