People aged 65 and older are increasingly in need of emergency health care, and one of the best places to get this is the hospital. And with the percentage of the US population projected to more than double between the years 2010 and 2050, so too will the demand for emergency care.
Unfortunately, emergency department (ED) visits can be confusing and intimidating for many people in this age range. Not only is ED often loud and chaotic; health professionals are more likely to conduct quick initial evaluations simply because of the crowding of patients of all ages. This can lead to assessments often too brief to cover the full scope of a geriatric’s medical history and medications.
It’s a good thing that the last few years have seen EDs moving into a more “geriatrics-friendly” direction, with an increasing amount of health institutions recognizing the importance of geriatrics principles or the branch of health care that deals with the care we get as we age.
As such, here are seven essential characteristics of geriatrics-friendly emergency care that should help put your mind at ease if you’re an older person or someone taking care of a senior.
In a geriatrics-friendly environment, older people are placed in a system that frequently checks on their well-being, helping reduce confusion and complications. This is because while it’s true that everyone deserves the same level of care and attention in an ED, older people tend to be more delicate.
As such, a geriatrics-friendly ED ensures older people are comfortable, warm, well-fed, mobile (if at all possible), and are not left alone for long periods. Doing so reduces the risk of developing delirium, making the experience generally less stressful for both patients and caregivers.
Training in the Care of Older Adults
A geriatrics-friendly ED is also one where staff is specifically trained in emergency care for older adults. While patients of all ages are treated in EDs, older people tend to have different needs for their bodies, and staff like social workers and specialized nurses should be well trained to handle this.
Additionally, staff should also be trained to screen for health problems that are common for people aged 65 and up during a check-up. These include checking their ability to walk a short distance, think clearly, or maintain attention, and how they take care of themselves at home. These screening questions often provide a clear image of how much medical care or attention an older person needs, as well as how quickly they can recover should they get admitted.
Attention to Medications
A geriatrics-friendly ED also follows a system to ensure every older patient is getting their proper medication. Because older people tend to have more health problems, they often take more medicine than the average patient.
Because of this, EDs should use different tools and systems to ensure patients don’t get incorrect medication or medication doses. Standard tools include medication reconciliation and full pharmacy reviews.
Attention to Geriatrics During Care Transitions
Usually, older adults admitted to a hospital go through “care transitions,” where they will be moved between different locations several times as they recover. For example, one patient may come from a nursing facility and get transferred into an Intensive Care Unit before being transferred to a standard hospital room. From here, they can prepare for rehabilitation before eventually getting discharged.
During each of these transitions, a patient will require different types of care. It is the ED’s job to make sure that these transitions and changes are as smooth as possible. Doing so helps with their recovery and ensures that everyone is coordinated with the patient’s needs.
Attention to Your Personal Care Goals
Each patient has their personal care goals, and a geriatrics-friendly ED must provide that. This is usually expressed through an “advance directive,” a legal document that explains what kind of end-of-life care someone wants based on their personal preferences.
If possible, this document should be brought to an ED visit. If you or someone you’re taking care of doesn’t have one, it’s essential to talk to them about it before an actual emergency occurs.
Because caregivers play an essential role in looking after older patients, geriatrics-friendly EDs must also have an effective system to keep them comfortable and included during an older person’s ED visit.
Chances are, caregivers are well-aware of their patient’s preferences, so they can assist in ensuring their patient gets the help they deserve and prefer.
Providing the Right Physical Setting
Aside from specialized care through training, geriatrics-friendly EDs should also provide the right physical setting for their older patients. This includes special furniture, equipment, and visual elements like hearing devices, reading glasses, pressure-reducing mattresses, non-skid floors, handrails, and even bedside portable toilets, as all of them are equally important.
When this is provided, geriatrics tend to be more comfortable and find it easier to hear and see around them. Of course, unique protocols in these spaces should also be followed.