St. Joseph Mercy Health System tailors care to seniors with new ER

Tina Witkowski, left, shows off one of the new rooms at St. Joseph Mercy Hospital's senior ER during an open house and tour of the facility Wednesday.

Lon Horwedel | AnnArbor.com

An elderly diabetic patient had been a regular visitor in the ER at St. Joseph Mercy Ann Arbor.

But the visits stopped after the patient received a new brand of treatment in the hospital’s new senior ER.

Staff gave her a cognitive screening, asking her to remember three objects and then draw a clock, and discovered that she couldn't follow the instructions. It was her cognitive function, not her diabetes, that led to the unnecessary trips. It was also unlikely that she could properly treat her diabetes without help, caregivers determined.

The woman received treatment at a 12-bed senior ER that opened this fall in a repurposed space near the existing ER.

A ceremony at St. Joseph Ann Arbor on Wednesday formally marked not only the facility's arrival, but also a change in philosophy from the typical rush-rush world of emergency medicine.

Staff has received special training, with an emphasis on slowing down. An increase in staffing supports that approach. Doctors and nurses can spend more time with each patient. And they use the time to ask questions that explore depression, cognitive ability, the potential for interaction with existing medications, and patients' living conditions in order to help identify problems and make improvements.

“The amount of seniors with depression has been alarming,” said Jennifer Dunn, manager of the emergency room.

Adults who bring older parents to the ER are often shocked to learn of a parent’s cognitive decline, she said.

The comprehensive approach is meant to improve the way the aging population is treated and make what could be a frightening and disorienting experience tolerable and productive, hospital officials said.

Those with urgent problems such as heart attacks are treated in the regular ER, while individuals with milder complaints, like leg cramps, are seen at the senior ER.

Seniors entering the ER will find pleasant lighting and glare-free, no-slip floors. The private rooms are outfitted with flat screen TVs and high-tech beds to assuage pressure points and prevent falls. A big white board outlines the care plan for the day. Discharge instructions come with bigger fonts, and large-print puzzle books and reading glasses are also available in ample supply. The repurposed space has the capacity to expand to hold 22 seniors at a time.

This type of care is increasingly important as baby boomers hit 65 this year, said Rob Casalou, CEO of St. Joseph Mercy Health System’s Ann Arbor, Saline and Howell hospitals. Over the next 20 years, the senior population is expected to double, he said.

“The senior ER model considers the needs of patients and adapts to meet those needs,” he said.

But it also aims to keep individuals who could receive better care at home outside of the hospital altogether, he added. The need might be for home care or hospice care, rather than emergency medicine. A medical social worker reviews all charts to help determine how to best meet each patient’s needs.

The senior ERs are available at all St. Joseph Mercy hospitals in southeast Michigan, including Saline, Chelsea, Brighton and Livingston.

Juliana Keeping is a health and environment reporter for AnnArbor.com. Reach her at julianakeeping@annarbor.com or 734-623-2528. Follow Juliana Keeping on Twitter.