For the Elderly, a New Kind of ER


Geriatric ERs Still Face Questions

Cost is also a concern. New facilities, new equipment, and additional staffing are all things that cost money. Most emergency departments operate on very limited budgets, so there is fear that hospitals will invest in these geriatric areas at the expense of other aspects of emergency care.

"I am concerned it may take away resources from other critically ill patients," said Dr. Juan March, professor in the Department of Emergency Medicine at Brody School of Medicine, East Carolina University.

And most importantly, is this what patients really want? Hospitals may find it challenging to offer these services to those who need and appreciate them while maintaining respect for the 'younger' more independent seniors who may find their assignment to these areas offensive.

While most physicians would agree that new design features being implemented in geriatric emergency departments are positive changes, some argue that the efforts are being misdirected. Rather than target the older population, the changes might be more effective if applied to emergency care in general.

"Why not add these benefits to our already existing ED's and improve patient care for all ages?" Ahmed said.

Dr. Gabe Wilson, associate medical director in the Department of Emergency Medicine at St. Luke's-Roosevelt Hospital Center agreed that these changes may apply to a bigger group than just seniors. He said he sees the new safety measures as particularly important.

"It is not just older patients that are at higher risk of fall; in fact, many younger patients may be seeking care for a condition that temporarily places them at higher risk of fall," Wilson said.

Mahon feels fortunate that her hospital was able to create this option for their patients, but admits that it may not feasible for all hospitals. Her advice to other facilities? "People don't have to do things identical. A smaller hospital might not be able to have a separate senior area, but look at what resources you do have and get creative."

Will geriatric emergency treatment areas be standard design in hospitals of the future? The jury may still be out on this issue, but the concept draws much needed attention to the challenges that emergency physicians face every day in providing care to the growing geriatric population.

"The number of older patients seeking care in the emergency departments in the U.S. will continue to substantially increase over the next decade, making this a very important topic that needs to be addressed," Wilson said.

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