Treating older patients presents both great challenges and rewards. I have been blessed to have had the opportunity to help a huge number of older patients and find it has taught me a great deal about life and the human condition.
The last years of life can often cause the most positive and fruitful person to suffer maladies
and indignities completely out of their control. We, as acupuncture doctors, can’t completely prevent this of course, but we have very useful tools to help those experiencing some of the negative aspects of the final chapters of their lives. Acupuncture stimulates and facilitates the best use of the body’s natural resources, helping the body to better manage a wide range of disorders. Because acupuncture relies on natural, intrinsic resources, it is safer than manmade pharmaceuticals and surgery. This superior safety profile is especially important in the management of geriatric patients as the shock of surgery may be too great and that patient group tends to have a lower tolerance for the side-effects of pharmaceuticals.. While improved nutrition and public health measures has allowed more people to enjoy better health into their later years than had been the case in generations past, we are also seeing a greater number of geriatric patients who survive well into their 80’s, 90’s and beyond in greatly compromised health as mentioned above.
Acupuncture Philosophy approach in Geriatrics It is quite interesting to consider that the oldest and most significant Chinese medical Classic – the so called “Yellow Emperor’s Classic” (YEC) opens with the Yellow Emperor asking his court physician a question related to geriatrics.
He states that in ancient times people lived past 100 years of age and now are worn-out at half at age and he asks his physician why that should be. In short, he is told that the people had “lost the Tao” i.e., their connection with nature. The YEC is full of references to Taoist concepts so a brief summary of these concepts as they relate to aging is fitting here. Taoist philosophy teaches that the concept of yin/yang is the most essential to understanding nature. One of the “Laws” of yin/yang is that everything must have an opposite. A fundamental application of the law of opposites is that all things that are born (created) must die (perish). So aging leading to death is the inevitable flip-side of creation leading to conception and birth. More specifically, life is the combination and interaction of Fire/yang/shen and Water/yin/Jing essences (Qi). Fire qi relates to the heavens above us and Water Qi to the earth below us. 
It is the nature of Fire to rise upwards and of Water to flow downwards. Life is the interaction or intermingling of the Fire and Water essences but, as their tendencies are to move in opposite directions, they will eventually disassociate in “ashes to ashes, dust to dust” fashion. In terms of our physical (material) bodies, Water or yin/jing qi is our most vital essence. We are literally born within a fluid-filled environment of the womb and are replete with Water qi in our early years. Our physical aging process can well be thought of as a “drying-out” process - we continually loose our Water essence as we age. Our skin, hair, joints, internal organs and glands - all dry-out as we age. Reproduction takes a heavy toll on this Water essence as you can’t get something out of nothing in the material realm (although Taoism teaches that the material realm itself is generated from its opposite non-material partner). At the other end of the spectrum, our Fire or yang/shen Taoist Philosophy in Geriatrics .
It is quite interesting to consider that the oldest and most significant Chinese medical Classic – the so called “Yellow Emperor’s Classic” (YEC) opens with the Yellow Emperor asking his court physician a question related to geriatrics. He states that in ancient times people lived past 100 years of age and now are worn-out at half at age and he asks his physician why that should be. In short, he is told that the people had “lost the Tao” meaning their connection with nature. The YEC is full of references to Taoist concepts so a brief summary of these concepts as they relate to aging is fitting here. Taoist philosophy teaches that the concept of yin/yang is the most essential to understanding nature. One of the “Laws” of yin/yang is that everything must have an opposite. A fundamental application of the law of opposites is that all things that are born (created) must die (perish). So aging leading to death is the inevitable flip-side of creation leading to conception and birth. More specifically, life is the combination and interaction of Fire/yang/shen and Water/yin/jing essences (qi). Fire qi relates to the heavens above us and Water qi to the earth below us. It is the nature of Fire to rise upwards and of Water to flow downwards.
Life is the interaction or intermingling of the Fire and Water essences but, as their tendencies are to move in opposite directions, they will eventually disassociate in “ashes to ashes, dust to dust” fashion. In terms of our physical (material) bodies, Water or yin/jing qi is our most vital essence. We are literally born within a fluid-filled environment of the womb and are replete with Water qi in our early years. Our physical aging process can well be thought of as a “drying-out” process - we continually loose our Water essence as we age. Our skin, hair, joints, internal organs and glands - all dry-out as we age. Reproduction takes a heavy toll on this Water essence as you can’t get something out of nothing in the material realm (although Taoism teaches that the material realm itself is generated from its opposite non-material partner). At the other end of the spectrum, our Fire or yang/shen qi blazes upward as spiritual/mental energy. As this essence continues its separation from the Water essence this causes mental/emotional disturbances including excessive thoughts, memory loss, anxiety, sleep disturbance, and mental confusion. Gauging the Odds of Success Both the drying-out of our jing qi and blazing-out of our shen qi are inevitable consequences of aging. However, as with any of the many consequences of aging, some people will naturally tend to lose some capabilities sooner or at a greater rate than others. Some will experience greater loss in their hearing or vision, for example, sooner or to a greater degree than others. So, while it is a general feature of the aging process that one’s vision, hearing, joint flexibility, etc., will suffer or that one will lose one’s hair or develop wrinkled skin, it is not the case that everyone will experience such losses to the same degree and at the same age. Some may lose their hearing fairly early while maintaining better than average vision, for example. While it is natural to age it is also natural that the breakdown of aging will not impact everyone equally.
Why is this important to consider in learning about geriatric acupuncture? 
Because - while acupuncture can’t reverse the inevitable tide of nature, it does have the potential to help health problems that are the result of an unnatural pathology. Remember your Chinese Medicine text books describing the difference between an “inherited” health issue and one that develops as a result of unhealthy life habits? We have a better chance of helping the later than the former. The same applies in geriatric medicine. An elderly patient that experiences vision or hearing loss may not necessarily be beyond help if that loss was due to something other than the natural aging process. You need to try to understand each case individually and choose acupuncture points according to the situation of the individual case.