Already strained and overcrowded, emergency departments are gearing up for a dramatic rise in the older-adult population. A makeover is needed, positioning emergency units as the “front porch” of the hospital instead of the “front door,” writes Manish Shah, M.D., M.P.H., co-author of a paper in Health Affairs.
As a front porch, the ER would remain a safety net for seniors who need to be admitted, but could also act as a partner to coordinate care for people eligible to be sent back into the community, said Shah, associate chair for research at URMC’s Emergency Department. (A “silver tsunami” is expected by 2050, when the number of people 65 and older is expected to double and those 85 and older will triple, the authors say.)
The Health Affairs report offers several recommendations and areas where more research is needed, including: The addition of special geriatrics ER observational units with interdisciplinary staff; greater use of telemedicine programs; community-based paramedics who specialize in geriatrics and can identify and help frequent users of ERs; and improved patient hand-offs between service providers.
The December issue of Health Affairs examines the state of emergency care in the United States. “Transforming Emergency Care for Older Adults,” includes work by Shah, first author Ula Hwang of Mount Sinai, and others.
Click here to read the full report.
Leslie Orr |
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