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What is a Geriatric Consultation at MGH Senior Health?

A consultation is a comprehensive evaluation by a specialist in Geriatric Medicine of a new or existing problem being experienced by a patient age 65 or older. In addition, we offer caregiver support consultation with a Licensed Geriatric Social Worker.

What is the goal of the consultation

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

• An independent in depth assessment of a specific condition.
• A review of the patient's current care plan for that condition.
• Advice about the above and,
• If appropriate, alternative management approaches and/or tests for further evaluation of the condition.

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.

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

• Medicare will cover your consultation at the same level (80%) that it covers your office visits. If you have a secondary insurance such as Blue Cross - Medex or AARP they will pick up the remaining 20%. Please check for deductibles at the beginning of each calendar year.
• 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.

How long will the consultation take?

The consultation is scheduled for 90 minutes to provide time for 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 or psychiatrist can be available to participate in the follow up consultation. This is a separate service but can be arranged to coincide with the follow up consultation visit.

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 or bring copies of discharge summaries from any recent hospitalizations, 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.
• Bring all the medication bottles for the physician to review during the consultation.

What kinds of problems are evaluated during the consultation?

The consultation service often sees common problems which interfere with the patient’s independence or ability to function during their everyday activities. Some examples include:

• Memory problems.
• Change in mood or behaviors.
• Difficulties with walking
• Difficulties with personal care.

What kind of report will the consultant develop?

Depending on the nature of the problem, the consultant will provide a report which includes the patients 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 patient’s primary care physician will continue to be responsible for long term care of the patient.

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 is offered at a discounted hourly rate in conjunction with the patient’s medical visit. This service can not be billed to insurance. Please call 617-726-4600 for appointment and current charges.

Examples discussions include:

• Home health care arrangements
• Evaluating resources in the community to help 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 facilites.