Hospitals prepare to care for an aging ER population

Many elderly patients end up in the emergency department, so that's a key place to start to improve geriatric care, experts say.

Hospitals see more elderly patients as the population continues to age, and as a result plan to retool their approach to emergency care to better suit the greater numbers of seniors.

Facilities in the San Diego region, for instance, are planning geriatric-specific emergency departments and have offered training to help emergency physicians better care for seniors. Kaiser Permanente’s San Diego Medical Center, the newest in the city, was built with nonslip floors, adjustable lighting and a computerized guardrail system, all of which are designed to reduce fall risk and cater to patients with delirium, according to an article from The San Diego Union-Tribune.

San Diego Medical Center and other hospitals in the region, like Palomar Health, are working on new hip fracture protocols to improve outcomes for elderly patients. UC San Diego’s hospital in La Jolla will open its geriatric ER next year, and Scripps Memorial Hospital La Jolla’s revamped emergency department was built with seniors in mind; it has glass doors and walls to reduce noise and a 16-bed “decision center” where patients meet with geriatric specialists.

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As the Baby Boomer generation ages, elderly people will make up a greater share of the population. Seniors are some of the most vulnerable patients to treat, often visit the emergency department, and many have multiple comorbidities. Estimates suggest that as many as 25% of ER patients are seniors, a number that’s likely to increase when 1 in 5 Americans are aged 65 or older in 2030, according to an article from Medscape Medical News.

Hospitals across the country are embracing geriatric-specific ERs to better treat this population, hiring staff trained specifically in handling the needs of seniors. About 100 of these facilities currently operate, and the number is growing.

But do these changes really save money and improve health? Experts like Tess Hogan, M.D., director of geriatric emergency medicine at the University of Chicago and a researcher, say yes.

Hogan told the Tribune that improved care for seniors can reduce readmissions, save hospitals money and often allow these patients to stay at home, where they’d prefer to be. The financial investment in boosting geriatric care can be minimal, too, she said, as it could just require additional training to improve clinician awareness about the needs of elderly patients.

Much of the investment, too, is in helping ER clinicians direct patients to crucial care outside of the emergency department, Zia Agha, M.D., chief medical officer at West Health in San Diego, told Medscape.

“I think part of the work around geriatric emergency care is not only to improve the care that happens in the ED, but also to surround the ED staff with the resources that allow them to provide safe care outside of the ED facility—to onboard patients toward a better trajectory, so that they can do better and not have rebound admissions,” Agha said.