Geriatric Consult: For Assistance with a Known Medical or Social Issue

If you are caring for a loved one, relative or friend with a specific medical issue, a geriatric consult may be beneficial.

What is a geriatric consult?

A geriatric consult is a scheduled appointment with a geriatrician (and other members of the Geriatric Medicine team as needed). In some ways, a geriatric consult is similar to a Geriatric Evaluation and Management (GEM) assessment, except a consult focuses on a specific situation or medical condition.

For example, you may seek a consult if your loved one needs a comprehensive discharge and recovery plan after emergency surgery or is dealing with health complications related to malnutrition. In the first instance, the consult would be with a Cleveland Clinic geriatrician and social worker/discharge planner; in the second, it would be with one of our geriatricians and/or a diet and nutrition consultant. All records, test results and suggestions generated during a geriatric consult are shared with the patient's primary care physician.

While a geriatric consult focuses on a specific situation or condition, it is "like a GEM assessment" a holistic consult that draws upon the expertise of Cleveland Clinic's entire geriatric team, as needed. During and after a geriatric consult, team members will work closely with you and your loved one's primary care physician to coordinate care.

The geriatric consult team includes some or all of the following:

  • Geriatrician
  • Certified nurse practitioner
  • Social worker
  • Nutritionist
  • Rehabilitation therapist
  • Consulting pharmacist
  • Geropsychiatrist

When is a geriatric consult advised?

Geriatric consults are strongly advised if the patient's primary care physician would like outside expertise to help evaluate and coordinate care for a specific age-related condition, or if the patient:

  • Is frail, over age 75 and lives alone
  • Is taking multiple medications to manage chronic health conditions
  • Has impaired heart, kidney, liver and/or lung function
  • Has memory impairments, Alzheimer's disease, or is experiencing significant cognitive decline
  • Is depressed
  • Has been hospitalized and will require long-term rehabilitation
  • Lacks a good support network
  • Requires help with end-of-life care and/or decisions
  • Consults also are advised if the patient has experienced a medical emergency, such as a stroke or fall that results in hospitalization; has undergone stressful treatments or surgery; or is transitioning to a new age-stage or living environment.

What is the cost of a geriatric consult?

Costs of a geriatric consultation usually are covered by Medicare Part B. Many private insurance companies also cover some or all of the costs. Costs of diagnostic tests and referrals to consult team members are covered by Medicare Part B and by many private insurance companies. Specialists may bill separately, but referrals for their services will be reviewed with you and your loved one before the services are ordered.

How do I or a loved one make an appointment for a geriatric consult?

As the person's primary caregiver, you may make an appointment for a geriatric consult. The patient's primary care physician also may refer the person. If the person is in the hospital, the hospitalist (attending physician) may schedule an appointment. In addition, the Geriatric Medicine team accepts referrals from community health care providers, including local offices on aging and senior centers.

To make an appointment, call 216.444.5665 or toll-free 800.223.2273, ext. 45665.

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