The need for multiple reforms in today’s flawed healthcare system is glaringly obvious, and overcrowded emergency rooms are nothing new. Yet they’re a particular problem for seniors, whose unique needs and challenges remain largely unmet. Current standard emergency room setups and protocols are designed to get patients in and out as quickly as possible. Seniors require an entirely different approach.

Why Now?

On the blog Planetinsane.com, Nadia Beten notes that seniors over 75 are the largest group using emergency rooms other than newborns. Every day now, more than 10,000 Baby Boomers turn 65, and will continue to do so for the next 19 years. Some forward-thinking organizations have started making changes in preparation. With 20% of the population estimated to be 65 and older by 2030, it’s a timely decision.

Leading the Way

Holy Cross Hospital in Silver Springs, Maryland holds bragging rights for establishing the first Senior ER in the country. Open since 2008, they spent years doing research to get all the details right, from thicker mattresses, warming blankets, and noise reduction to better lighting, walls painted in colors that soothe aging eyes, and special floors that reduce risk of falling. The entire medical staff is trained in geriatrics with full-time geriatric social workers also on staff. Patients are respected, with time and care given to careful screenings, comprehensive assessments, and making sure instructions upon discharge are fully understood. Follow up care by phone is frequently included. This is especially important since a study by Dr. Kirsten Engel of Northwestern University (published in the Annals of Emergency Medicine) shows that 78% of patients from the general population do not even fully understand the care and discharge instructions they received in the Emergency Department. When you consider the elderly population and add dementia to the mix, the problem intensifies.

Following Suit

Park Plaza Hospital and Medical Center in Houston, Texas, St. Joseph’s Regional Medical Center in Paterson, New Jersey, and St. Joseph Mercy Health System in Washtenaw County, Michigan have also established Senior ERs. In Peoria, Illinois, Methodist Medical Center has opened a Senior ER, topping off their services with the “Methodist Dot Squad”. These volunteers act as advocates and provide emotional support for seniors who arrive alone, coming by ambulance or from a nursing home. They hold patients’ hands, help contact friends or family as needed, and assist in asking questions on the patients’ behalf.

Patient-Led Services

Dr. Bill Thomas, a geriatrician and professor at the Erickson School at the University of Maryland, Baltimore County, helped design the Senior ER at Holy Cross. In an NPR story, he comments on the importance of structuring emergency services around older people’s needs, rather than the other way around. He also reminds us, “Good care of older people teaches us how to take good care of everybody.” Perhaps it’s a lesson we need to relearn.

Thank you to the editor, Heidi Enriquez, and to Rosser321 for letting us use your photo.