Marble Valley Healthworks Geriatric Medicine

Seth Coombs, MD, and Bruce B. Bullock, MD are board-certified physicians with experience in geriatric medicine. Each takes a holistic approach to care that emphasizes healthy aging and prevention, while also taking into consideration the importance of maintaining independent living and social support. Our doctors have years of experience managing subacute rehabilitation, and visit patients at all of the area’s residential rehabilitation facilities. Serious illness or injury can lead to long hospitalizations followed by nursing home stays and rehabilitation. Our patients enjoy the reassurance and security of knowing that their doctor will be involved with their care every step of the way, and will be working hard to return them home as safely and independently as possible.

Dr. Coombs and Dr. Bullock work to prevent and treat diseases, conditions, and disabilities that commonly affect older adults. Their focus includes the management of chronic conditions, prevention of falls, coordination of multiple medications, and following the cognitive changes that often occur with aging. The team at Marble Valley HealthWorks also understands the importance of end of life care. We work hand in hand with home health providers, visiting nurse agencies, assisted living facilities, and hospice services to ensure our patients and their families receive comprehensive and attentive care when they need it most.

End-of-Life Care Options

Advance Directives

An advance directive is a written document, signed by an individual patient and two witnesses, that outlines the individual’s wishes for medical treatment in the future when he or she no longer can (or wishes to) make decisions about what to do.


A COLST form is a written document in which a patient dictates specific limitations in her care (such as to not receive mechanical breathing support) when she decides it is no longer in her interest.

Caring for an
Elderly Parent?

Do you need to care for a parent
during a major health crisis?

Marble Valley Healthworks concierge physicians can help coordinate the transfer from hospital to residential facility or home-based care for elderly patients facing new challenges to their lifestyle and independence.

Marble Valley Healthworks, can help you create an Advance Directive or COLST to ensure your end-of-life and other critical healthcare decisions will be honored. To learn more visit: Vermont Department of Health or the Vermont Ethics Network.