Alter the space to make ED senior-friendly

Train staff to meet seniors’ needs

Because the needs of the senior population are different from the needs of younger patients, hospitals should make changes to create an emergency department geared to the needs of seniors, says William Thomas, MD, an elder care expert who is working with Livonia, MI-based Trinity Health on geriatric issues and development of the senior emergency departments.

The physical environment should be altered to accommodate the physical needs of older people, Thomas adds. The staff in the emergency department have to receive specific training in the care of elders, and the way care is provided should be reorganized to include an emphasis on pharmaceutical issues such as medical reconciliation and social issues that could interfere with the patients’ living independently in the community. The organization’s culture also must change to ensure that the needs of older people are a consistent part of the care process, he adds.

Senior emergency departments should have no-glare lighting with dimmer switches in the rooms, non-slip, non-glare floors, hand rails, and grab-bars throughout the entire area to accommodate the needs of seniors, Thomas adds. Pressure-reducing mattresses, blanket warmers, and clocks, calendars, and telephones with large buttons all create a senior-friendly environment.

Because of noise buffers, the senior emergency department is much quieter than the main emergency department, says Sue Penoza, RN, MA, strategic planning director for Trinity Health. Materials the staff give the patients are in large print, and reading glasses and hearing devices are available for people who need them.

“When we began developing our senior emergency departments, we reviewed the skills and knowledge the staff needs to take care of the elder population and developed recommendations for the education of nurses and physicians, as well as for other caregivers such as patient care assistants,” Penoza says. The health system offered educational sessions around ageism, created videos, and offered workshops on working with the senior population.

The hospitals included the education in the hiring and orientation process. “Our senior emergency departments focus on delivering evidence-based, patient-centered care to elders who are relying on us to help them achieve the best possible outcomes,” Penoza says.