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Our aging population is a hot conversation topic these days, so I was fascinated to learn about one hospital’s approach to the seniors in its ED: it’s taking pains to accommodate them. National Public Radio’s Morning Edition reported on Holy Cross Hospital in Silver Spring, Md., which has set up a separate ED for patients 65 and older.

From the color of the walls (golden brown) and type of flooring (non-slip wood paneling) to sound barriers and thicker mattresses, the needs of seniors were considered when the hospital built the new facility last summer. 

But the physical space is only part of the story. Staff in the new ED includes a full-time social worker and physicians and nurses trained in geriatrics. The overall idea is to change to meet the needs of older people, rather than the other way around, said Bill Thomas in the NPR report. Thomas is a geriatrician and University of Maryland professor who helped design the new unit, which cost $150,000 to build and is designed to treat patients over 65 who do not require urgent cardiac care.

There are a host of reasons why an ED visit can be harrowing for seniors, including loud sounds, bright lights, and rapid staff interaction. On the medical side, there is often a focus on the symptoms that brought the patient in that day, rather than the patient as a whole. And a lack of follow-up means patients who fall may go home to house full of tripping hazards, and those sent home with a prescription sometimes have no way to fill it.

At Holy Cross, attention is paid to the fact that a long wait and lack of information can be particularly difficult for seniors, especially those with dementia or hearing loss. Both clinicians and social workers work to ensure anxiety about being in the ED is tended to alongside the patient’s physical comfort. After the patient returns home, he or she receives a follow up phone call the next day, with the goal of lowering the rate at which older patients return to the ED.

Beyond the fact that this is a terrific idea, I like that Holy Cross took the difficult situation presented by seniors in the ED and viewed it as an opportunity to both provide better care and differentiate itself. This seems like something hospitals can, and should, do more of.

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Summer 2013

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