Next Avenue: Geriatric ERs Provide Better Care for Older Patients

Suffering from frail health in her 70s, Dr. Mark Rosenberg’s mother had to make repeated trips to the emergency room of a South Florida hospital. It was loud and chaotic, and seeing trauma victims and people with drug overdoses added to her distress.

“One day she got so upset she left the emergency department against medical advice because she was so afraid to be there,” Mark Rosenberg says. “She called me up and said, ‘You need to build an emergency department for people like me.’”

It was no idle comment. Rosenberg, chair of emergency medicine at St. Joseph’s Health in Paterson, N.J., heads one of the nation’s busiest ERs, and he knew his mom’s complaint was justified.

He got together with his mother, her sisters and her bridge partners to discuss what the ideal ER for older and frail individuals would look like. Using their advice, St. Joseph’s University Medical Center in 2009 opened the nation’s first geriatric emergency department.

Since then, the concept of ERs designed with older patients in mind has spread across the country. Dr. Kevin Biese, an emergency medicine physician at UNC Health Care in North Carolina, says geriatric emergency departments are distinguished by four features:

• Nurses and doctors trained to work with older adults
• Age-friendly design elements, such as thick mattresses, dimmed lights and non-skid floors
• Risk assessments for older adults to identify factors that could exacerbate health problems
• Ability to connect patients with community resources they need to stay healthy

In most cases, the term “geriatric emergency department” doesn’t mean a separate emergency room. Rather, it refers to a special type of care for older patients. “If you’re an older adult, you can know that the care team has an awareness of your unique needs and vulnerabilities,” Biese says.

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