“I like being examined here.” This phrase is often written elderly patients in the early dementia screening test geriatrician Dr. Evridikis Kravvaritis. “At some point, the test asks them to write a full sentence, many choose to express gratitude to their doctor,” Dr. Kravvaritis describes in “K”.pathologist-geriatrician, academic fellow of EKPA, on occasion run at the People’s Hospital of the first geriatric clinic. The practice accepts patients older than 75 every Wednesday from ten in the morning until one in the afternoon. The team consists of herself, a physiotherapist and a doctor, a graduate of the postgraduate program in geriatrics, which has been established by EKPA since 2018. , doctors with higher education in related fields and graduates of medical sciences,” says she, who studied in Athens Medicine but acquired the specialty of geriatrics in the US, given that in Greece it was not recognized as a specialty until today. “A master’s degree is proof of theoretical training, but does not guarantee professional rights,” explains Dr. Kravvaritis.

Careful

Until the relationship between the geriatrician and the patient reached this level, they passed many crash tests. “They come with children, very cautious, some agree to me in order to avoid a visit to a psychiatrist or neurologist, which is taboo for their generation. There is also an urban myth that a geriatrician will give them a vitamin that will give them wings, and when I debunked that myth, they were disappointed.”

Patients react violently to possible changes – they don’t want to have an assistant at home, so as not to lose autonomy, they don’t want to wear a cane, because “what will people say?”, they don’t want to. I want to spend money on tests that do not cover the funds, leave them to my children and grandchildren … Most people, faced with a new doctor, feel insecure. “It’s ageist racism in reverse,” Dr. Kravvaritis laughs. “I win their trust when they see that I want to listen to their requests and spend time with them, which they really appreciate.” The examination, at least for the first time, takes more than one hour, while, ideally, a second examination should be done within the next 3 months. “The Anglo-Saxons say this in a schematic way: a brown bag review – that is, we are asked to look in detail at all the drugs that the patient is taking and at his recent tests.”

Our cells enter the aging process from the age of 25; officially, old age begins after 65 years. “In the US, in the public health system, when a patient turns 65, they are automatically referred to a geriatrician,” notes Dr. Kravvaritis. “However, age cannot be an absolute criterion,” he clarifies, “those who have played sports or are in constant physical movement in their lives are in a completely different situation than their peers.”

Therefore, the parameters on the basis of which the patient should be referred to a geriatrician were determined: increased complexity and comorbidity, which later leads to polypharmacy, problems with mobility, as well as psycho-intellectual. “It is important that each of us as doctors take into account the value system of each patient and his worldview,” he emphasizes, “and adapt the treatment regimen to our own wishes.” For younger people, this may seem unimaginable, “however, I have met many patients for whom the issue is quality of life, and not necessarily prolongation.”