WVU Medicine Geriatrics meets the growing demand of specialized care for older adults

MORGANTOWN, W.Va. – Before Rebecca Hopwood, 76, moved back to her hometown of Hopwood, Pennsylvania, from California, she made a call to WVU Medicine Geriatrics. As a former patient, Hopwood was eager to have access to geriatric care again.

“Having a quality geriatric service has been very important toward maintaining my health,” she said, noting that without the team at WVU Medicine, “I feel certain my health would not be as good as it is.”

About 18 percent of the United States population is over the age of 65, with the number expected to increase to 22 percent by 2040, as noted by America’s Health Rankings. West Virginia ranks as the fourth oldest state in the country with 21.5 percent of its population age 65 or older. 

Even though the population is aging, the number of geriatricians – doctors who specialize in caring for older adults – is shrinking. In fact, according to the American Geriatrics Society, there are fewer than 7,000 geriatricians in the country. 

Ten years ago, there were no geriatricians at WVU Medicine J.W. Ruby Memorial Hospital, but since then, the Geriatrics Program has blossomed. A dedicated team of four geriatricians, a geriatric fellow, and additional staff lead a program that is the only one in the state to offer older adults clinical care across multiple specialty clinics, including:

• The WVU Medicine University Town Centre Geriatric Clinic, offering primary care services for adults aged 65 and older with an emphasis in chronic diseases, memory problems, and behavioral issues.
• The Memory Health Clinic at the WVU Rockefeller Neuroscience Institute, providing comprehensive, individualized diagnosis and treatment for dementia.
• Geriatric Oncology, a referral-only outpatient clinic at the WVU Cancer Institute, aimed at improving care and quality of life for older adults with cancer.
• The WVU Frailty Clinic in conjunction with the Neuroscience Institute’s Department of Physical Medicine and Rehabilitation, which helps patients regain strength, mobility, and independence by offering specialized assessment, treatment, and rehabilitation.
• A Geri-Trauma Clinic, where geriatricians perform a comprehensive geriatric assessment and provide education to older adults after fall and trauma admissions by the WVU Medicine Jon Michael Moore Trauma Center.

“Patients with access to a geriatrician should take full advantage of it,” R. Osvaldo Navia, M.D., division chief of Geriatrics, Palliative Medicine, and Hospice, said. “The main strength of geriatricians is that we understand this population.”

“Just like young children benefit from seeing a pediatric specialist, older people benefit from being cared for by someone with special expertise in Gerontology,” Renee Bergner, 90, of Morgantown, said. 

Bergner said Dr. Navia’s expertise is evident when he helps her with medication management for her multiple chronic conditions. Not only can geriatricians help patients understand their medications, but they can also help optimize dosages and identify any potential interactions.

Communication is a key strength of geriatricians, as they must coordinate their patients’ care with other providers, all while keeping the overall goal of the patient in mind.  

Hopwood sees several specialists, including one outside of WVU Medicine, and she said Navia communicates with all of them. “He is the quarterback, as I see it, and refers for expertise as needed,” she said. 

Understanding the goals of care is important when determining the course of treatment. Navia and the other geriatricians on staff are certified in palliative medicine, a huge asset for patients who would not benefit from aggressive treatment but instead require quality-of-life management. Assisting patients with issues like frailty, memory, and mobility can still improve their overall well-being.

“We advocate for the patient first,” Navia said. He added that his palliative medicine training helps him communicate better with all stakeholders involved in a patient’s care. Listening to and understanding all the unique positions helps him make informed decisions. 

“He considers my preferences,” Bergner, who has been a patient of Navia’s for nearly a decade, said. “He makes sure that his advice is fully understood.”

Overall, Navia said his goal is to improve each patient’s quality of care by properly balancing all aspects of treatment. 

“Many patients through the years feel things changing,” he said. “We can communicate, we can adjust the medications and care they need, and we can give simple recommendations for them to manage their own health.” Navia recommends patients exercise, stay sociable, read, be proactive, and stay functional to help prevent or keep age-related conditions at bay. 

“It is quite valuable to have an organized approach to your health,” Hopwood said. “You can’t do it alone.”

With a rapidly aging population, serious challenges lie ahead for the small number of geriatricians already in the field. Navia hopes to see the creation of an aging center that integrates multiple specialties and providers from different fields, researches the social aspects of aging, and provides community resources. He said this could raise awareness of the needs of older patients and their families at the state level.

“We have this wonderful team, geriatric clinics, and interdisciplinary clinics, and we are training geriatricians here as well. But it’s just in Morgantown,” Navia said. 

“We would like to replicate the same system in other parts of the state. We would like to see geriatricians in the rural areas where they are really needed. We would like to provide education to primary physicians and expand this geriatric philosophy. The most important thing is to keep our options open on how we can help this population.”

For more information about WVU Medicine Geriatrics, visit WVUMedicine.org/Geriatrics.