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Posted on Sat, Aug 21, 2010 : 6 a.m.

St. Joseph Mercy Health System will have specialty ER services for seniors

By Tina Reed

All St. Joseph Mercy Health System emergency departments will have specialty services for seniors by January in a bid to better treat Washtenaw County's growing population of older adults.

Earlier this week, the health system announced that it will be increasing geriatric medicine training among doctors and nurses in its eight emergency departments. It will also change standard protocols for patients over the age of 65 and improve the sensory experience for senior citizens in waiting and treatment rooms.

St. Joseph officials say they're the first Senior Emergency Department implemented in Michigan.

"Many older adults' care is more complicated and complex because they may have several chronic conditions, they may be taking multiple medications," said Joann Grosh, director of senior services for Saint Joseph Mercy Health System and co-chair of the Senior Emergency Department initiative. "Their care needs to be looked at differently."

St_joe_hospital.jpg

All St. Joseph Mercy Health System emergency departments will have specialty services for seniors by January.

File photo

The initiative is one of the first changes the health system is making as part of a comprehensive plan to prepare for the aging Baby Boomer population - the oldest fast approaching their 65th birthdays.

It's part of a growing trend among emergency departments nationwide to better accommodate the expected boom of older patients.

Research has shown increasing evidence that older adults need to be treated differently.

For example, a study published by the American Geriatrics Society pointed out the design of emergency departments usually isn't set up well to provide care to geriatric patients, even though they are more likely to end up in the department than other patients.

Emergency departments are set up for quickly triaging patients and diagnosing them; they are often crowded, noisy and are flooded with bright fluorescent lighting.

It can make it difficult to effectively care for older patients who may have multiple health problems, may have cognitive impairments or difficulty hearing or seeing, and can make it easier to miss subtle symptoms of acute illness, the study pointed out. It can also lead to a lack of understanding of medical instructions by the senior patients.

By the start of the year, the St. Joseph Mercy's senior emergency departments may have larger fonts on signage and paperwork, bigger clocks on the walls, noise buffers and the availability of reading glasses and hearing amplifiers, and pressure-reducing mattresses.

The departments will also have different lighting, change flooring to materials that are less likely to be slippery or have a glare, and also make modifications to better dampen noise and add bigger nurse call buttons.

Officials say those changes could help - not only in making a patient experience more comfortable - but also increasing the likelihood seniors will understand information being provided while in the emergency department.

Behind the scenes, the changes may have an even bigger impact, officials say. Nurses in each emergency department will have been trained in geriatric medicine and care.

Patients will be evaluated or treated for risk of falling, potential medication risks, pre-existing conditions, dementia, living condition concerns, nutrition and depression. Since St. Mary Mercy Livonia began offering the program, it has had favorable responses, said Garry Faja, president and chief executive officer of the health system.

Each person visiting the senior emergency department will be evaluated for physical function, cognitive status and level of risk. A care plan will be developed upon discharge.

The goal is to catch any diagnosis, medication problems or other situations that might land the patient quickly back in the hospital again.

"All that in the end is looking at saving health care dollars because of improving patient outcomes," Grosh said.

Tina Reed covers health and the environment for AnnArbor.com. You can reach her at tinareed@annarbor.com, call her at 734-623-2535 or find her on Twitter @TreedinAA.

Comments

annarbortownie

Sun, Aug 22, 2010 : 5:14 a.m.

Interesting. I commented before any comments were logged and mine is not here. It is a wonderful idea but given my experience at St Joe's ER with a senior member of my family they have a long way to go! The care and and special needs were not met. Seniors often arrive from a care facility and are feeling very disoriented and confused. The ER did not seem to understand that. This needs to be addressed. Perhaps it would be a good idea for St Joe's to survey the families of seniors who have been in their ER in recent years.

mkm17

Sat, Aug 21, 2010 : 9:48 p.m.

I agree with the post by Juno! My Mom has Alzheimer's Disease, and trips to the ER are traumatic for her. The care by the doctors, nurses, and PA's and U-M has been excellent, but the experience for Mom in the ER triage has been traumatic for her. Many readers have made good comments here, but the bottom line is that the patient has to feel comfortable and cared for or they won't go to the doctor or the ER in the first place.

15crown00

Sat, Aug 21, 2010 : 9:38 p.m.

Good idea but talk is cheap. Certainly i wish them success.Elderly people quite often need more attention.

Alan Caldwell

Sat, Aug 21, 2010 : 8:03 p.m.

This is very good news for the community in general and for seniors in particular, and a great example for other ERs to follow. The care will be improved and more cost effective. Thank you to St. Joe's and to Joann Grosh!

msddjohston

Sat, Aug 21, 2010 : 3:42 p.m.

This is great news! Thank you. I am thinking of traveling to the St. Joe and perhaps register or prompt them that there is this senior out here who has these stats and then some. (It is better to have them prepared way ahead of time, even if it is years ahead of any emergency.) Thank you againj!

julieswhimsies

Sat, Aug 21, 2010 : 12:40 p.m.

This is indeed good news! As I approach "Senior" status, I may well seek out a personal physician who has privileges at St. Joe.

Juno

Sat, Aug 21, 2010 : 9:36 a.m.

I am so pleased to hear this! Ten years ago, when my father was suffering from Alzheimer's, visits to the emergency room were traumatic for him, stressful for us, and difficult for the ER staff which was not equipped to handle his situation.

that's a tuffy

Sat, Aug 21, 2010 : 9:34 a.m.

You have got to be kidding. They call it triage for a reason, the patients who are in most danger get treated first. It doesn't matter if you are 5 or 85. Let the trained professionals do their jobs. The only way to get faster treatment is to have more nurses and doctors, and that means more money. We know money is in short supply.

David

Sat, Aug 21, 2010 : 9:05 a.m.

Congratulations to St Joe's for taking the lead in recognizing that many Seniors have different sensory capabilites and may struggle to understand and accept their limitations. I am a CAPS, Certified Aging In Place Specialist, and address many of these same issues as I design and/or install remodeling changes for my older clients.

MjC

Sat, Aug 21, 2010 : 8:28 a.m.

This is a brilliant idea! The staff of independent assisted living centers take no chances when elderly residents take a sudden turn for the worse (falls, fainting, unexplained illness). The family is called and often the only place to go for immediate answers is the ER. Sometimes it's a simple case of dehydration or a forgotten medication. An ER set up specifically for the elderly will save time, energy, and of course provide a huge cost savings to the hospital. Way to go St. Joe's!

Visiting

Sat, Aug 21, 2010 : 6:19 a.m.

This is fantastic news! Kudos to SJMH for recognizing the care and treatment needs of the elderly in our community. Training ER staff in geriatric medicine should result in better outcomes for senior patients. I hope SJMH will be an example for all hospitals to follow!