Emergency Rooms Are No Place for the Elderly --- Over the last five decades, quality emergency care has become synonymous with speed. Survival rates for patients in the throes of a stroke, heart attack or traumatic injury depend on the number of minutes needed to triage, diagnose and treat. Even the physical environment where emergency care takes place has become a paragon of medical efficiency — large echoing spaces that can be divided at a moment’s notice with panels of curtains, slick linoleum floors that can be mopped up in minutes and bright fluorescent lights. -- More recently, as overcrowding has become a significant problem, the drive for efficiency has become more pronounced, with doctors and nurses having to work as quickly as possible simply to see all the patients. -- But when it comes to elderly patients, it is nearly impossible to work quickly. Many are plagued by multiple chronic diseases like diabetes, high blood pressure and heart disease, take numerous prescription drugs that can cross-react in potentially dangerous ways and suffer from ills like dementia that can make the answer to even the simplest of questions – What brought you to the emergency room today? – difficult to understand. --- For several years now, a small but dedicated group of emergency medicine and geriatrics specialists has been working to improve this situation. And over the last three months, first in an article published in the national health policy journal Health Affairs, then in an impressive set of evidence-based guidelines supported by several national professional medical and nursing organizations, they have issued a call to arms to the rest of the medical profession. -- To meet the needs of the rapidly growing elderly population, these specialists assert, medical centers must “geriatricize” their emergency departments. -- “Older adults aren’t the kind of patients people gravitate toward,” said Dr. Ula Hwang, lead author of the paper in Health Affairs, a member of the task force that compiled the guidelines and an associate professor of emergency medicine and geriatrics and palliative care at the Icahn School of Medicine at Mount Sinai. “There’s a reason you don’t see the frail, cognitively and functionally impaired older patient on television medical shows.” -- Nonetheless, Dr. Hwang and her colleagues remain optimistic. About 50 medical centers have incorporated such changes into their emergency departments, a notable improvement from a decade ago, when none existed. And by emphasizing close attention to the individual’s experience, many of these redesigned departments are not only improving care but also redefining what is possible for doctors and patients, even in one of the most critical of care settings. -- “We can really become partners in improving care, instead of just putting a Band-Aid on the problem,” Dr. Hwang said. “We can give our elderly patients, our parents and our grandparents the kind of respect and understanding that we owe them.” - More, PAULINE W. CHEN, M.D.- NYTimes, at: http://well.blogs.nytimes.com/2014/03/13/emergency-rooms-are-no-place-for-the-elderly/?rref=health&module=Ribbon&version=origin®ion=Header&action=click&contentCollection=Health&pgtype=Blogs