A New Kind of ER for the Elderly

iStockphoto/Thinkstock(NEW YORK) — Monitors beeping, loud voices and people scurrying about are just a few things people associate with a busy emergency department.  Many people may consider these factors a nuisance, but for older patients, it can be downright frightening and even affect their health.  A new trend in emergency department design is seeking to optimize the environment in which older patients are treated.

Referred to as “geriatric” or “senior” emergency departments, these facilities have been popping up across the country since the first one opened at Holy Cross Hospital in Silver Spring, Md. in 2008.  They are usually small areas, away from the hustle and bustle of the main emergency department.  Private rooms, simple layouts, natural lighting, more volunteers and soothing music are among the many features Holy Cross and other hospitals across the country are adding, all aimed at creating a calm and comforting environment.

Beyond making older patients more comfortable, the focus is really on keeping them safe.  Dr. James Del Vecchio, medical director and pioneer in the creation of Holy Cross Hospital’s senior emergency center, thinks their follow-up service is one of the most important safety features of the care provided. 

Social workers are instrumental in this process. They not only set up home nursing services, but they make follow-up calls to every patient within 48 hours of being seen.

“They are checking to make sure the patient was able to get all the prescriptions or doctor appointments that they needed,” Del Vecchio said.

Managing medications is another area where these senior facilities hope to intervene.  At the Holy Cross Hospital, any senior who comes in on five or more medications has their prescription list reviewed by a pharmacist before leaving. 

According to Bonnie Mahon, director of senior services, “We’ve had some real saves from this.  One woman kept falling until our pharmacist realized that the dose of one of her medications might be causing this.”

Bed sores, one of the most common complications of hospitalization, are associated with higher costs and longer hospital stays.  Research shows that these wounds can occur in as little as four to six hours, suggesting they may be starting to form while the patient is still in the emergency department.  But the Geriatric ERs are addressing that problem as well.

Instead of the traditional thin layer of foam covered in plastic, thicker mattresses, such as the four-inch Tempur-pedic ones at Holy Cross, are being used in hopes of reducing the occurrence of these wounds.

Del Vecchio also points out that every senior who comes through the door is asked eight to 10 simple questions that help screen for problems that seniors are more prone to, ranging from memory impairment to risk for falls at home.

And to combat falls in the hospital, Holy Cross has modified the flooring and lighting.  Mahon explains that some types of lights can create shiny spots on the floor.  This interferes with depth perception and can lead to falls, especially in the elderly.

These changes in emergency care have been well received by the senior population.  DelVecchio and Mahon say their patient satisfaction scores are over 95 percent positive.

Copyright 2012 ABC News Radio

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