Senior ER Provides a New Standard of Care for Geriatric Patients and Their Families
A complicated interaction of vulnerability, frailty and acute illness places older adults at great risk for cognitive and functional decline. Given the growth in elderly populations, changes in geriatric patient care will impact every level of health care delivery. By addressing those needs in the emergency setting, hospitals can dramatically improve the transition back to home or other health care setting, minimize emergency room “bounce-back,” and better prepare caregivers for whatever is to come.
Population analyses make the necessity of different ER care patterns for geriatric patients abundantly clear:
- 12.7 percent of the U.S. population is over 65 years old.*
- Average length-of-stay for those older than 64 is 7.8 days, compared to 5.4 days for those under 64.*
- 85 percent of seniors present more than five co-morbid conditions (heart disease, CHF, anemia, UTI, pneumonia, etc.), and 76 percent take more than five medications.**
*The Center for Disease Control and Prevention, National Center for Health Statistics
**UH Bedford Medical Center, a campus of UH Regional Hospitals, ACE rounds since 2010
Staff Specially Trained to Recognize and Treat Conditions Affecting Geriatric Patients
In response, University Hospitals created the region’s first Senior ERs at UH Bedford and Richmond Medical Centers, campuses of UH Regional Hospitals. Emergency Department personnel received extensive training to better recognize and treat the acute and chronic medical conditions specific to the geriatric population. This includes:
- Real-time consultation with clinical pharmacists and social services
- Optimized communication with nursing homes, assisted living facilities and patient families
- Coordination of care with nursing home medical directors, administrative directors and primary care physicians
- GENE certification for nurses
Use of evidence-based screening tools to evaluate geriatric syndromes – including dementia, delirium, depression and functional ability – provides critical insight into how an acute illness is affecting the older adult. It also provides measurable data to assist in developing that plan of care which will best help the patient return to baseline cognition and function.
Senior ER Provides Comprehensive Health Assessments and Follow-Up Care
The goal is to meet the unique needs of each patient, not only in terms of the crisis that prompted the ER visit, but also in terms of his or her entire health care situation. This includes:
- Medication review for those who have experienced a fall, an acute mental status change, or those taking medications that might be of risk for an older adult
- Thorough assessment to discern possible risk for elder abuse, neglect, noncompliance or substance abuse
- Further screening for geriatric syndromes such as depression, dementia, delirium or functional decline
- Involvement of social service to assist in meeting psychosocial concerns
- Collaboration with family/caregiver to insure older adult care needs are met
- Assessment for caregiver strain
- Telephone follow-up with patient and/or caregiver to insure safe transition back to home or other health care facility
Special Features Provide Comfort and Reduce Risk of Disorientation or Injury
The Senior ER is also configured with soft lighting, pressure reducing mattresses, visual and hearing assistive devices, large-print signage and skid-resistant flooring. These features reduce confusion, disorientation, anxiety and the risk of falls.
Find Out More
For more information about the Senior ER at UH Richmond Medical Center or to request
a presentation about this new service, call 440-585-6329.