Senior-friendly ED, what about senior-friendly CARE? Focussing about changing things our own department or hospital is a certainly great and I would encourage everyone to engage yourself into changing one thing about geriatric care. Great project usually starts with small project. The thing is, this silver tsunami issue is not only happening in the ED, it is invading the whole health care system.
This week, I attend a conference about geriatric friendly hospital and I heard many great things.
First, the term senior-friendly hospital will fade out to become senior-friendly care. This is amazing because the right way to take care of the increasing number of older adults is to think about a global initiative. Community, hospital, department, beds, they all in this together and they can help each other out.
You may think, how can the community care help our emergency department issues? In fact, the solution is IN THE COMMUNITY. We are the front door, (I know Dr Melady, it may be better to think about being the front porch but there is snow and cold in Canada so we don’t let patients out!) and our patient mostly comes from the community. The population is aging, 65 years and older account for 42% of our Ontario admission, and 59% of our hospital days. The thing is, only 10% of 65 years and older are frequent flyers in the ED and represent 60% of our health cost. We need to have an alternative way to take care of these people other than to send them to the ED. Here are some great ideas!
- Volunteers are abundant in the community and they can be trained to screen our high risks elderly and communicate their needs to the right professional. This way, we can prevent frailty and eventually frequent ED users. If you want more information, go to healthtapestry.ca;
- I talked about this before but I want to emphasize that this is a very interesting solution to use our paramedic efficiently in the benefit of patients.
- Alternative housing. There is a housing gap for elderly who needs functional assistance but does not have the financial potential to get to a private nursing room. The only alternative is Long-term care facility and they end up waiting in hospital, blocking a bed, slowing our patient’s admissions. We collectively need to think about a solution for them.
- Promoting mobility and exercise for our pre-frail/frail and even very fit elderly in the community. This is a prevention intervention that will certainly maintaining quality of life and health longer.
- Improving transition of care. When you discharging a patient, make sure that the plan is clear for the patient, their family or their nurse and that a follow up is reasonably organized. This way, you may increase compliance to your treatment and a successful result, and then a further ED visit?
- House calls team. A interdisciplinary team specialized in geriatric care that go into our frail non mobile older adults suffering from multiple comorbidities with the objective to keep them at home safely and as long as possible.
- Nurse outreach team.
They are many more, think outside the box, use your imagination.
Those are just a few ideas and the amazing thing about geriatrics is that it is a small world and any idea could turn into a GREAT idea and then, a potential solution for a giant issue. Make your blue print, this world is yours !