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COMMENTARY: Graying of America reshapes care

Posted On: Nov. 20, 2011 12:00 AM CST

COMMENTARY: Graying of America reshapes care

Now that your parents are getting up in age, you've decided to prepare this year's Thanksgiving dinner to give your mom a break.

After your sumptuous feast, your father complains of chest pains and shortness of breath. Your mother teases him, attributing it to heartburn from a second helping of your decadent pumpkin-pecan pie.

But you know your dad has a heart condition. What do you do? If you live in the Denver area, you could take him to Colorado's first emergency room designed specially for seniors.

Exempla Lutheran Medical Center opened its Senior ER in Wheat Ridge, a suburb of Denver, on Oct. 4 after an analysis of historical ER utilization showed that 21% of patients were over age 65, said Jan Dionne, program manager for senior emergency and trauma services at the hospital.

Because conventional hospital emergency rooms usually are noisy and chaotic, they can be stressful and debilitating for older patients. “We wanted to create an environment that fosters healing,” said Ms. Dionne, a registered nurse with advanced training in geriatric medicine.

Each of the eight examination rooms in Exempla Lutheran's Senior ER are separated by walls rather than curtains to provide solitude and privacy.

The normally glaring fluorescent lights are dimmer and the beds are topped with thicker, supportive mattresses. The Senior ER also is equipped with plush recliner chairs on wheels for patients with conditions that prevent them from lying flat. To assist patients who arrive without their eyeglasses or hearing aids, magnifying glasses and “pocket talkers”—amplification devices that resemble iPods—are provided. The floor of the Senior ER even has a nonskid surface to prevent slips and falls.

In a resource room adjacent to the Senior ER, a case manager is available on a daily basis to help address post-hospital care—a godsend for families of patients whose employers do not provide elder care referral services.

Although the ER is dedicated to patients over 65, younger patients who exhibit dementia or delirium—conditions normally associated with old age—have been treated there.

Exempla Lutheran's investment is a proactive response to our aging society. According to 2010 U.S. Census figures, nearly 60 million U.S. residents are older than 60, representing almost 20% of the population. In fact, hospitals nationwide are transforming the ER experience for the elderly.

My niece, Amber, is considering medical school, and my brother is urging her to specialize in geriatrics because he will be 60 by the time she graduates. While such a career path would provide her with job security, she would probably be too busy caring for other patients to tend to dear old dad. The American Geriatrics Society reports that there is roughly one geriatrician for every 2,600 people, and that number could fall to one for every 3,800 older U.S. residents by 2030.