When you think of a hospital emergency room, what comes to mind? An overcrowded waiting area filled with coughing people. Hard chairs that make you squirm. A harried staffer who seems so aggrieved and overwhelmed that you’re cowed into submission.
If you’re older, this unwelcoming environment only adds to your anxiety when you’re already ill and possibly disoriented.
In recent years, there’s a promising trend that targets the ever-growing number of seniors who head to the hospital with a medical emergency: geriatric emergency departments (GEDs). These specially designed and equipped emergency rooms aim to improve care for older adults.
Read: The risk of dementia is high. Here’s how to prepare
In 2018, the American College of Emergency Physicians (ACEP) began accrediting hospitals that follow certain guidelines in treating people over 65. There are three levels of accreditation (gold, silver, bronze) that correspond to the number of best practices the hospital implements.
Examples of best practices range from specially trained physicians and nurses with education in geriatric emergency medicine to nonslip floors, enhanced lighting and high-quality signage. GEDs are also stocked with supplies tailored for seniors such as canes and walkers.
“A lot of people take for granted that a hospital has all the equipment that older folks need for mobility,” said Elizabeth Goldberg, an associate professor of emergency medicine at Warren Alpert Medical School of Brown University. “But that’s not always the case.”
There are about 180 accredited GEDs in the United States. To find out if there’s one near you, go to ACEP’s website and click on “Accreditation List.”
“GEDs are growing at an increasing rate because hospitals thrive on recognition” and accreditation is a way they can differentiate themselves, said Kevin Biese, chair of ACEP’s geriatric emergency department accreditation program. The number of Americans over 65 is projected to double by 2060, creating an opportunity for hospitals to revamp their systems of care to cater to this booming market.
Read: My parents are unprepared for retirement — how can I help them?
There are different types of GEDs. Some include a specialized unit with dedicated space within an emergency department. Others provide geriatric care—sometimes overseen by physicians and nurses with geriatric emergency care expertise known as “champions”—through an existing emergency department.
Depending on the facility, seniors may use the same emergency entrance as everyone else. But it’s what happens next that’s different.
If a 78-year-old woman arrives with a broken wrist from a fall, a traditional emergency room will identify her problem and treat it. But a GED would screen her more thoroughly.
“They might ask if this was her first fall, look at her meds to see what might have caused her fall and set up a home-safety evaluation to help prevent future falls,” said Biese, who’s also an emergency medical physician. “As a hub, the GED will look at connecting patients to community resources that are available and care transition” upon discharge.
In addition to physicians and nurses with training in geriatrics, GEDs often have physical therapists, occupational therapists, pharmacists and social workers as part of the team. They can address mobility challenges, medication interactions and cognitive problems.
“GEDs can reduce hospital admission rates,” said Lauren Southerland, director of clinical research for the department of emergency medicine at the Ohio State University Wexner Medical Center. Seniors with dementia, nutrition needs or mobility problems gain access to a range of health care providers as well as other support such as Meals on Wheels. This increases the odds that they’ll get continuing help at home that prevents another hospital visit.
Hospitals might advertise their commitment to seniors. But just because they promote their geriatric emergency services does not mean they deliver as promised.
Some hospitals with self-proclaimed geriatric emergency departments lack ACEP accreditation. That doesn’t mean they’re trying to deceive you; they may be in the process of upgrading their care delivery to older adults.
“But beware of a hospital that [claims to have] a geriatric emergency department but then rushes you with a quick assessment [when you check in], lacks comfortable seating and has poor signage,” said Jane Carmody, a program officer at the John A. Hartford Foundation in New York City.
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October 20, 2020 at 10:02PM
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Does your hospital have an emergency room designed for seniors? - MarketWatch
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