Emergency room visits can be traumatic, and the stress can double when the patient is elderly.
Health care providers believe some basic changes in emergency department design – such as reducing noise and glare – can make older patients more comfortable and even safer.
Dozens of hospitals nationwide are taking it a step further by designating separate emergency areas for geriatric patients, including Novi, Mich.-based Trinity Health, which has opened 16 so far with more planned.
But local officials say that’s not practical here, where the elderly population isn’t large enough to justify the expense. Instead, they say, local emergency rooms have been designed to ease the experience for all patients – old and young.
U.S. census figures show 12 percent of Allen County’s population is 65 years or older, and that percentage is destined to grow as baby boomers age. The Census Bureau estimates the number of people 65 and older will double nationally in the next 20 years.
Dr. Tom Gutwein, medical director of Parkview Health’s emergency departments, first heard of designated geriatric emergency rooms three years ago, when Parkview was planning its regional medical center, which opened March 17.
Officials discussed the idea extensively, he said. They ultimately opted to create one emergency space that could serve any patient.
“We wanted to be as flexible as possible with our emergency department,” he said.
Parkview Regional Medical Center incorporates various features found in geriatric ERs, including larger rooms to allow family members to accompany elderly patients, who might have trouble recalling their medical history.
The hospital’s youngest patients and their parents also benefit from larger rooms, Gutwein said.
Examining rooms each have two doors, including an exit to an exterior hallway, so family members can come and go without disturbing other patients.
Individual rooms have walls and doors that keep out noise better than curtains, which were commonly used as dividers in emergency rooms 10 years ago.
Thicker mattresses on the cots also help prevent bedsores for patients who are bedridden.
Parkview isn’t the only local provider that has changed to accommodate elderly emergency patients.
St. Joseph Hospital, in downtown Fort Wayne, invited representatives from Senior Circle to tour the ER and offer suggestions for upgrades. Senior Circle is a national non-profit organization dedicated to improving the lives of people ages 50 and older.
Jason Amich, St. Joe’s administrative director of emergency services, invited the feedback and authorized several changes as a result, including installing softer lighting in place of fluorescent bulbs and painting walls a warmer, more neutral color.
Senior Circle members suggested offering older patients more soft food choices, including cottage cheese, fruits and vegetables. They also recommended warm blankets be made available for patients who chill easily.
Like Parkview, St. Joe invested in 5-inch-thick mattresses for patient beds. St. Joe is part of the Lutheran Health Network.
But caring for elderly patients is about more than aesthetics.
Parkview has educated its staff about elderly patients’ needs and what’s newly available to help them, including updated stroke treatments, Dr. Gutwein said.
Patient rooms throughout Parkview Regional Medical Center include updated safety features geared toward the elderly, spokesman John Perlich said.
All patients rooms are private, which reduces noise. Shower floors are flush with the bathroom tile, reducing the fall risk. Smart bed technology alerts nurses if patients who are a fall risk try to get out of bed.
Natural lighting in all rooms helps elderly patients stay oriented to days and nights. And larger rooms with so-called family zones make it easier for family members – who might notice more subtle changes in behavior or condition – to stay with the patient.
Before patients are released, nurses take time to educate them and caregivers on medications, Perlich said.
Gutwein believes the hospital’s design and protocols serve all patients – including geriatric ones – very well. But Parkview officials will continue monitoring the situation to ensure they do meet elderly patients’ needs.
If they’re not, he said, Parkview will set aside a separate space.
St. Joe officials believe current efforts are working well there. Starting a year ago, Amich said, 100 percent of the hospital’s satisfaction surveys completed by patients 65 or older have given the hospital’s emergency room the highest possible rating.
A local advocate for the elderly is satisfied by local health care providers’ choice to create emergency rooms that are welcoming to seniors rather than designating separate ERs for elderly patients.
Jenni Showalter, director of the Allen County Council on Aging, a division of Aging & In-Home Services of Northeast Indiana, believes the solution is appropriate, given limited resources.
Her only gripe is one probably shared by many: Showalter would like hospital admissions forms to be printed in larger type.