I understand the anxiety that comes with a first appointment. The family member who finally made the booking has been worried for weeks — or months. The elderly parent may be reluctant, or may not entirely understand why they are here. The family wants answers. Everyone is a little tense.
Let me walk you through exactly what happens when you come to see me, so there are no surprises.
Before the Appointment: What to Bring
The single most useful thing you can do before coming is to gather documents. A geriatric assessment is most productive when I have the full picture — not just what is happening now, but the sequence of events that brought you here.
Bring the following if you have them:
- All current medicines — ideally the actual boxes or blister packs, not just a written list. I need to see the exact dosage and formulation of each medicine, because discrepancies between what is prescribed and what is actually being taken are common.
- Recent blood test reports — within the last 6 to 12 months. Particularly useful: complete blood count, kidney function, liver function, thyroid, blood sugar, B12, and vitamin D.
- Imaging reports — any CT or MRI scans of the brain, X-rays, or other imaging, even if older.
- Previous specialist letters — reports from cardiologists, neurologists, orthopaedic surgeons, or any other specialist the patient has seen.
- A discharge summary — if the patient was recently hospitalised.
If you do not have all of these, come anyway. We will work with what we have. But the more context I have, the more useful the appointment will be.
Who Should Come to the Appointment?
The patient should come if at all possible — even if they are reluctant or uncertain about why they are here. I will speak with them directly; their own account of how they are feeling is important.
But I would also strongly encourage a family member or caregiver to attend. This is not because the patient cannot speak for themselves — it is because patients and families often notice different things, and the combination gives a much richer picture. An elderly person may not volunteer certain concerns in a clinical setting (particularly around memory or falls), while a family member may have observations that the patient has not noticed or would not think to mention.
If the patient is anxious about coming, reassure them that this is a general health review — not a test they can fail. That framing is accurate: geriatric assessment is not about labelling, it is about understanding the whole picture.
The Assessment Itself: What I Am Looking At
A comprehensive geriatric consultation is not a single-disease consultation. I do not focus on one complaint and leave. The purpose is to evaluate multiple dimensions of the person’s health — and their interaction — in one sitting.
Here is what I typically cover:
Medical history and medications
I will go through each health condition and each medicine. I am looking for whether the treatment is appropriate for an elderly person specifically — many medicines that are safe in a 40-year-old carry different risks at 75 or 80. I am also looking for interactions between medicines, and for medicines that may no longer be needed.
Physical function
I will ask about daily activities — what the person can manage independently, what they need help with, and what they have stopped doing. I will also look at gait and balance, because falls in the elderly are both dangerous and preventable. If necessary I may do a brief walking assessment in the consulting room.
Cognitive screening
If there are concerns about memory or thinking, I will do a brief standardised cognitive assessment. This is not frightening — it involves questions about orientation, short-term recall, language, and some simple tasks. It takes about ten minutes and gives me a useful baseline. I will explain what the results mean clearly.
Mood and mental health
Depression is significantly underdiagnosed in elderly patients. It is often mistaken for personality change, or dismissed as an understandable response to illness and loss. I screen for depression routinely because it affects everything else — physical recovery, compliance with treatment, quality of life — and because it responds well to treatment when properly identified.
Nutrition
Unintentional weight loss in an elderly person is a serious sign that needs investigation. I will ask about appetite, eating habits, and weight changes — both the family’s observations and the patient’s own account.
Social situation and support
Who does the patient live with? Who helps them? Are there informal caregivers who are themselves struggling? These are not incidental questions — they are central to what I can safely recommend. A care plan that ignores the patient’s actual living situation is not a useful plan.
How Long Does It Take?
A full first consultation takes 45 to 60 minutes. This is longer than a typical specialist appointment, and that is intentional. Rushing a geriatric assessment produces an incomplete picture, and an incomplete picture leads to inadequate recommendations.
For subsequent consultations, the review is shorter — but the first visit is the one where I need to understand the whole person.
What Happens After the Appointment?
At the end of the consultation, I will summarise what I have found and what I recommend — in plain language, not medical jargon. I will explain my reasoning, and I will make sure you have the opportunity to ask questions.
I will provide a written summary. This is important because a lot of information is shared during a long consultation, and it is very normal not to remember everything. The written summary gives you something to refer back to, and to share with other family members who were not present.
If further investigations are needed — blood tests, imaging, a referral to another specialist — I will explain why and help coordinate these. If medications need to be changed or reduced, I will be explicit about which ones, why, and what to monitor.
A Note on Home Consultations
Some patients cannot easily travel to the hospital — because of mobility, anxiety, or because the hospital environment is itself distressing for them. In these cases, a home visit through GeraVita may be a better first step.
A home assessment has its own advantages: I can see how the person actually functions in their own environment, observe the layout of the home for fall risks, check the medicines as they are actually stored, and have the conversation in a setting where the patient is more comfortable. The clinical content of the assessment is the same — it is simply conducted at home instead of at the hospital.
Home visits currently cover Newtown, Rajarhat, and Salt Lake.
Questions Worth Bringing to the Appointment
Many families find they go blank when they finally have a doctor’s attention. Here are useful questions to write down and bring:
- Which of these medicines can be reduced or stopped?
- Are there any tests that have not been done that should be?
- What is the most important thing we should be watching for?
- Are there signs that should prompt us to call you or come back urgently?
- What support services or specialists might help in our situation?
- What can we do at home to reduce the risk of falls?
- Is what we are seeing likely to progress? What does that look like?
There is no such thing as a silly question at a geriatric consultation. The entire purpose of the appointment is to give you a clearer picture — and you deserve to leave with that clarity.
Geriatric consultations at Manipal Hospital Broadway, Kolkata — and doctor-led home visits in Newtown, Rajarhat & Salt Lake through GeraVita.