Geriatric Consultation offered by the Mass General Geriatrics Unit

What is a Senior Health Geriatric Consultation?

The consultation is a comprehensive examination by a physician specializing in Geriatric Medicine of a new or existing problem being experienced by a patient age 65 or older.  A Caregiver Support Consultation with a Licensed Geriatric Social Worker may also be offered.

We offer consultation about specific medical problems such as:

  • Memory Problems
  • Alzheimer's Disease and Other Dementias
  • Neurological Problems
  • Falls/Difficulties with Walking
  • Constipation
  • Incontinence
  • Unexpected Weight Loss
  • Depression/Anxiety
  • Change in Mood or Behavior
  • Difficulties with Personal Care/Managing at Home

We also offer evaluations for patients who are experiencing increasing physical, cognitive or social frailty.

 

What is the goal of the consultation?

The goal of the consultation is to provide the patient and patient's caregiver with:

  • An independent, in depth assessment of a specific condition or general concern
  • A review of the patient's current plan
  • Advice about evaluation and management of the situation
  • If appropriate, additional tests for further evaluation

 

Who can make an appointment?

Any patient aged 65 and over can make an appointment or can be referred by their physician or a community agency.  Each patient must have a Primary Care Physician available to follow up on consultation suggestions.

 

Is a Geriatric Consultation covered under Medicare Part B and other insurance plans?

If you have standard Medicare, it will cover your evaluation at the same level (80%) that I covers your office visits.  If you have a secondary insurance such as Blue Cross – Medex or AARP, they will pay for the remaining 20%.  At the beginning of each calendar year, you may have additional deductibles.

If you are insured by ANY KIND OF MANAGED MEDICARE PLAN such as Secure Horizons or First Seniority you will need a referral from your primary care physician.  Please check your specific policy before arranging for this appointment as you will be responsible for any uncovered portion of this service.

 

What can I expect at the consultation? 

The 90 minute evaluation consists of a complete medical and social history, an examination, discussion about the findings and development of a plan.  Because of the complexity of some situations, patients may be asked to return for a follow up visit to complete the consultation process.  If appropriate, a social worker can be available to participate in the follow up consultation. 

 

Who can come to the appointment?

With the patient's permission, family or other concerned individuals are invited to participate so that a complete picture of the patient's problems can be obtained.  It is very helpful to have family or caregivers present who will be assisting in the implementation of the treatment plan.

 

What should be done to prepare for the appointment?

Because the consultant has a limited amount of time to spend with the patient and the patient's situation may be very complicated, IT IS VERY IMPORTANT THAT THE PATIENT

  • Arrange for medical records to be made available in advance for the physician to review 
  • Send of bring copies of discharge summaries from any recent hospitalization, a summary of recent events from the primary care or other specialists and any special testing that has been completed
  • Bring an up to date medication list or bring all the medication bottles for the physician to review during the visit.
  • Complete the enclosed forms describing the patient's current status and concerns. 

HAVING THIS INFORMATION AVAILABLE FOR THE CONSULTATION WILL ALLOW THE DOCTOR TO FOCUS ON THE PATIENT AND FAMILY CONCERNS.

 

What kind of report will the geriatrician develop?

Depending on the nature of the problem, the consultant will provide a report that includes the patient's history, physical examination and recommendations.  This report will be sent to the patient's Primary Care Physician who will work with the consultant to implement the recommendations.  The consultant will be available to the patient's physician to help with patient care around the issues of concern.  The patent's Primary Care Physician will continue to be responsible for long term care of the patient.  The patient will receive a copy of the recommendations.

 

What is the Geriatric Caregiver Consultation Service?

Our consultation service for caregivers is offered in conjunction with the patient's medical consultation.  An experienced geriatric social worker is available to assist family members and caregiver(s) with tools and solutions that help patients and their families manage the many challenges of aging.  The consult if offered at an hourly rate in conjunction with the patient's medical visit.  This service can not be billed to insurance.  Please call 617-726-4600 for further information and current charges.  Caregiver discussions may include:

  • Home health care arrangements
  • Evaluating resources in the community to manage care
  • Management of care among family members
  • Understanding limitations
  • Coping with chronic conditions
  • Medical and long –term care insurance
  • What to expect at assisted living facilities, continuing care retirement communities, nursing homes and rehabilitation facilities.

Please call Senior Health 617-726-4600 if you have questions about the Senior Health Geriatric Consultation Program.