What is a geriatrician, and when should you see one?

A geriatrician is a medical specialist who focuses on the health of older people. They are qualified doctors who have completed additional specialist training in the medicine of ageing, and their particular expertise is complexity: older patients who have several conditions at once, take a long list of medications, and whose problems do not sit neatly within any single organ or specialty. Where most specialists go deep on one system, such as the heart or the kidneys, a geriatrician's job is to look at the whole person and how everything interacts.

That is the practical difference worth understanding. If an older person is seeing a cardiologist for their heart, an endocrinologist for their diabetes and a rheumatologist for their joints, nobody in that group is responsible for the overall picture, including whether the combined medications are causing the dizziness or the confusion. A geriatrician takes on exactly that question.

What a geriatrician actually does

Their work usually covers some combination of:

• Assessing memory and thinking problems, and diagnosing the type of dementia where that is the issue
• Investigating falls, unsteadiness and dizziness, which often have several contributing causes at once
• Medication review, reducing or stopping medications that are no longer helping or are now causing harm. This is a genuine specialty skill and one of the most valuable things they do
• Assessing frailty and what can be done to slow or partly reverse it
• Managing incontinence, malnutrition and unexplained weight loss
• Advising on capacity and decision-making, which can matter for legal and care decisions
• Helping plan care, including whether someone can safely stay at home and what support would make that possible

They typically work across hospitals, outpatient clinics, memory clinics, rehabilitation units and sometimes visit residential aged care homes.

How they differ from a GP

A GP is the generalist who knows the patient over time and coordinates their care. A geriatrician is a specialist called in for a deeper assessment of a specific, complex problem in an older person.

The two are complements, not substitutes. In practice, a GP handles the ongoing care and refers to a geriatrician when a situation is complicated enough to justify a longer, more specialised assessment. After that assessment the geriatrician usually writes back to the GP with recommendations, and the GP continues the day-to-day management. Some people see a geriatrician once; others stay under their care for a period.

When to consider asking for a referral

There is no age at which a person automatically needs a geriatrician, and most older people never see one. It is worth raising with the GP when any of the following apply:

• Memory or thinking has changed noticeably, and you want a proper diagnosis rather than reassurance
• There have been repeated falls, or a fear of falling that is limiting activity
• The medication list has grown long, or new symptoms appeared after a medication change
• Several conditions are interacting and no single specialist is looking at the whole picture
• Someone has declined quickly after a hospital stay
• There is unexplained weight loss, weakness or a general loss of independence
• The family is trying to work out whether it is still safe for someone to live at home

If you are noticing changes but are not sure they warrant a specialist, our guide to signs your parent needs more support may help you decide what to raise with the GP.

How to get an appointment in Australia

You need a referral from a GP to see a geriatrician as a specialist. That referral matters for two reasons: it is normally required to claim a Medicare rebate, and it lets the geriatrician see the medical history rather than starting from nothing.

There are broadly two paths. Public, through a hospital outpatient clinic, a memory clinic, or an aged care assessment service, which is generally free but often has a waiting list. Private, in a specialist's rooms, which is usually faster but involves a fee, and Medicare typically covers only part of it, leaving an out-of-pocket gap. Ask the practice what the fee and expected rebate will be when you book, because gaps vary a lot between practices.

Some people first encounter a geriatrician through an aged care assessment or during a hospital admission, without needing to arrange anything themselves. If an aged care assessment is what you are heading towards, see our guide to what to expect at an ACAT assessment.

What happens at the appointment

Expect it to take longer than a standard specialist appointment, often an hour or more, because the assessment is deliberately broad.

The geriatrician will usually go through the full medical history, every medication including anything bought over the counter, and how the person is managing day to day: walking, washing, dressing, cooking, driving, finances and social contact. There is normally a physical examination, often including balance and walking, and there may be tests of memory and thinking. They may arrange blood tests or imaging.

Two pieces of practical advice make a real difference. Bring every medication, ideally the actual boxes rather than a list, including supplements and anything from the pharmacy. And bring someone who knows the person well, because a spouse or adult child often notices changes the person themselves has not registered or is inclined to downplay. Both are genuinely useful to the doctor, not just convenient.

After the assessment you should get a plan: what the diagnosis is, what to change, what to stop, what support to arrange and what to watch for.

Where they fit alongside other services

A geriatrician's recommendations frequently point towards practical support rather than more medicine: physiotherapy for strength and balance, an occupational therapist for the home, a dietitian, or ongoing help at home. Our guide to allied health for older people explains those roles and how to access them.

To arrange support at home after an assessment, contact My Aged Care on 1800 200 422. You can also browse health and wellbeing services near you on Our Mate.

Frequently asked questions

What is the difference between a geriatrician and a GP?

A GP is a generalist who provides ongoing care and coordinates everything. A geriatrician is a specialist in the medicine of ageing, brought in for a deeper assessment of complex problems such as memory loss, repeated falls or a complicated medication list. The geriatrician usually assesses and advises, then the GP continues the day-to-day care.

Do I need a referral to see a geriatrician in Australia?

Yes. You need a referral from a GP, both to access the specialist and to claim a Medicare rebate. Some people are referred instead through a hospital admission or an aged care assessment service.

Is there an age at which someone should see a geriatrician?

No. Referral is based on complexity rather than age. Most older people never need one, while someone with several interacting conditions, repeated falls or memory changes may benefit at any point in later life.

How much does a geriatrician cost?

It depends on the path. Public hospital and memory clinic appointments are generally free but can involve a waiting list. Private appointments usually attract a fee with a Medicare rebate covering part of it, leaving an out-of-pocket gap that varies between practices. Ask the practice for the exact fee and rebate before booking.

What should I take to a geriatrician appointment?

Take all current medications in their original boxes, including supplements and over-the-counter products, plus any referral letter, test results and a list of your questions. Bring a family member or friend who knows the person well, since they often notice day-to-day changes the person has not mentioned.