FYI Daily

A Better, Safer Trip to the E.R.

Last updated:

April 10, 2012
Emergency

One of the more fraught experiences for caregivers -- and their loved ones -- is a visit to the emergency room. And that's aside from the actual medical emergency! A new kind of emergency room is popping up around the country -- the "geriatric E.R." -- that's designed with older adults in mind, to reduce their stress and curb the repeat visits often associated with emergency hospitalizations, reports The New York Times.

What this looks like: No unnecessary waiting, chaos, and noise. Nonskid floors to prevent falls. Extra-thick mattresses to prevent bedsores. Reviews of medications to look out for underlying causes of emergencies. Visiting nurses to do home falls assessments to cut the risk of future falls. Skylights rigged with artificial lighting aimed at curbing sundowning.

Holy Cross Hospital in Silver, Spring, Maryland, opened one of the first geriatric emergency departments, which it calls a "senior emergency center," in 2008. Dozens of other hospitals from coast to coast now have or are planning similar units to cater to those ages 65 and up. Mount Sinai Hospital in New York City calls its brand-new geriatric emergency department a "geri-ed." Trinity Health System runs 12 such E.R.s nationwide, with plans to open seven more this year.

Hospitals are chasing the aging boom. Those over age 65 account for up to one-fifth of emergency-room visits. The specialty E.R.s also aim to provide more effective care by tailoring services to the unique needs of an older population. Within three months of hospitalization, up to 27 percent of older adults have another medical emergency, face another hospital admittance, or die, studies show. That's because they tend to have multiple chronic conditions and take multiple medications, and may have poorer communication skills to convey symptoms and history.

Good geriatric care is sensitive to these special needs and others, including pain management and hospital delirium, a common complication of hospitalizations for older adults.

St. Joseph's Regional Medical Center in Paterson, New Jersey, says its geri-E.R. has reduced unscheduled return visits to the E.R. to 1 percent of cases, down from 20 percent.

Critics say such services should be available to everyone in general emergency rooms. But others argue that just as there are pediatric hospitals staffed by those with special training and using special equipment, the same makes sense for the also-unique needs of the other end of the age spectrum.

Image by Flickr user taberandrew, used under a Creative Commons license.