Hospitals work to improve ER safety for seniors

Nobody enjoys a trip to the ER. But it can be especially difficult — sometimes even dangerous — for the elderly. Many emergency health-care settings are frenzied and noisy, with glaring lights and slippery floors, often without handrails. Cots and gurneys are hard on fragile bodies. Privacy is scarce.

“The emergency department is not a great place to hang out for anyone, but it can be especially tough if you are older,” says Denise Nassisi, director of the geriatric emergency department at the Mount Sinai Hospital in New York. “Many older patients are frail and have difficulty getting up and down from a gurney, or getting to a restroom. Some have cognitive dysfunction and don’t know their medical history. Some may have impaired vision or hearing. A crowded chaotic environment is not the best for them.”

According to the Washington Post, in recent years, recognition has been growing that older patients need a better ER environment and specialized care than the rest of the population. This has prompted many hospitals to introduce structural changes and new procedures to make their ERs age-friendly. The American College of Emergency Physicians launched an accreditation program last spring for the nation’s emergency departments to encourage them to adopt a more comprehensive and standardized approach for geriatric patients.

The percentage of Americans 65 or older is growing. It was 14 percent in 2012 and is projected to be 20 percent by 2030, according to the Centers for Disease Control and Prevention. About 49.2 million older adults live in the United States today, according to the American Geriatrics Society.

During 2012-2013, the incidence of adults older than 65 who sought emergency care was 12 per 100 persons for injury and 36 per 100 for illness, according to the CDC. The most common complaints that bring elderly patients to emergency departments are falls, abdominal pain, difficulty breathing, fever, chest pain, confusion or other cognitive issues, according to experts.

“Older adults are more vulnerable and have less reserve,” says Susan Zieman, a medical officer in the geriatrics and clinical gerontology division at the National Institute on Aging. “Somebody might fall and just plunk down on the floor, a ‘low mechanism’ fall for someone younger. But an older person can do serious damage — break a hip, for example. Also, sometimes they feel less pain, or show up with atypical symptoms, such as nausea, rather than chest pain, when they are having a heart attack. When people get into their 70s and 80s, there are some clear differences, [and] it takes specialty training to pick up these things.”

Read the full story at the Washington Post.

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