“It’s a terrible place to be if you’re older,” Corita Grudzen, MD, an emergency medicine physician with NYU Langone Medical Center, said of the ED, because the elderly are more prone to infections and delirium. Additionally, the aggressive tactics usually used in the ED may not actually extend their lives, she told Kaiser Health News.
Because of the droves of older people arriving in EDs across the country, hospitals are beginning to adapt their EDs to become more elderly-friendly, according to Kaiser Health News.
Here are two interventions hospitals have implemented to better treat older patients in the ED.
1. Screen for palliative care consultations. A screening tool named P-CaRES involves having clinicians answer a simple set of questions about ED patients. This can single out patients who might benefit from palliative care consultation. “Having that conversation in the ER, which is the entry point to the hospital, is vital,” Kalie Dove-Maguire, MD, a physician who uses the tool at UCSF Medical Center, told Kaiser Health News. It can help reduce suffering and put patients where they can receive the care that’s best for them.
2. Create a separate geriatric emergency room. Many hospitals have put geriatric ERs in place. They typically feature clinicians who are specially trained to diagnose and care for older people, according to another Kaiser Health News report. While geriatric ERs vary hospital to hospital, the American College of Emergency Physicians’ Geriatric Emergency Department Guidelines offer guidance for staffing, equipment, education, policies and procedures for geriatric EDs.
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