L+M, Westerly hospitals earn special geriatric accreditation
Jul. 23—NEW LONDON — With the country's 85-and-older population growing three times as fast as the general population, it's important that hospital emergency rooms be equipped to provide elderly patients with advanced care.
Nationally, 43% of emergency room patients are 65 or older, according to Jennifer Foss, Lawrence + Memorial Hospital's director of emergency services. What's more, she said, older patients' average emergency room stays are 20% longer than the overall average stay of five to six hours.
And 48% of the older people who come to emergency rooms end up being admitted to the hospital.
"They are our most vulnerable population," Foss said. "We have to have a staff with the skills to care for them."
With that in mind, the Yale New Haven Health System participated in the American College of Emergency Physicians' Geriatric Emergency Department Accreditation program, gaining recognition for all of the system's affiliates, including the emergency rooms at L+M and Westerly hospitals as well as the Pequot Health Center in Groton.
The accreditation has been awarded to just 13 health systems nationwide.
According to ACEP's website, www.acep.org, accredited hospitals' emergency rooms have adopted best practices for the care of the elderly, including education for all staff in regard to caring for older patients; screening for high-risk conditions specific to older people; "processes, protocols or procedures" that enhance care of older people; and formation of an interdisciplinary team of nurses, social workers, pharmacists, physio- and occupational therapists and physicians to improve assessments of older patients.
Foss said it's critical that emergency rooms accurately evaluate older patients, which can be challenging.
"I've always found it interesting, for example, that the elderly don't feel pain the same way as others, and in some cases they don't feel pain at all," she said. "And among them, there's a greater incidence of drug and alcohol abuse, which often is missed in emergency rooms."
It's important that older patients have their eyeglasses and hearing aids and are provided with walkers and canes during hospitalizations, Foss added.
"We know that older people seeking care in the Emergency Department have unique needs ... that are specific to their age group," Dr. Ula Hwang, professor of Emergency Medicine at Yale School of Medicine and an attending physician at Yale New Haven Hospital, said in a statement. "Through this accreditation process our providers are trained to look for signs and symptoms of syndromes and illness in the elderly that could be potentially life threatening if left untreated."
Clinicians at L+M and throughout the Yale New Haven Health have begun using the Confusion Assessment Method, which involves scoring a patient's responses to a series of questions and verbal tests designed to reveal delirium, disorganized thinking, a condition exhibited by up to 30% of older emergency-room patients, according to the ACEP.
Foss said delirium is often misdiagnosed and can have a medical cause or simply be the result of a disorienting emergency room environment. If not recognized, the condition can be life-threatening.
Delirium needs to be distinguished from dementia, which affects a patient over a long period and is almost always properly diagnosed, according to Foss.
She said L+M's Geriatric Emergency Department Accreditation should raise awareness among families in the region and give them confidence in the care the hospital provides.
"It shows our commitment," Foss said.
The other Yale New Haven Health System facilities that have received the accreditation include emergency rooms at Bridgeport Hospital's Milford and Bridgeport campuses, Greenwich Hospital, Yale New Haven Hospital's York Street and St. Raphael campuses and Shoreline Medical Center in Guilford.
