Today there are emergency departments designed especially for children. These are set up differently with specific and adjacent waiting areas. The staff are well-educated in the illnesses of children.
At the VA, there are specific mental health sectors in the ED to deal with traumatic brain injury, PTSD, and a host of illnesses that are best treated without visibility to the typical ED patients and families. Behavioral health has become synonomous with privacy and specific treatment regimes. At the very least, a standard ED department should have a mental health professional on staff at all times.
Why then, do we not provide a specialty ED for those over the age of 65? With the changing demographics of the US population and seniors predicted to out-number our children in the next 9 years, it is highly likely that senior ED's will be the norm. Seniors require medical staff with knowledge of their lifestyles and characteristic ailments. Gerontologists need to evaluate the patients and determine if they are capable of making their own medical decisions. If not, the families and caregivers need to be incorporated in treatment programs.
In her blog post, Anne-Marie Botek, listed the senior emergency room design offering:
- Floors with more traction and less glare
- Lighting that is gentler on elderly eyes
- Reclining chairs and mattresses designed to lessen pressure
- Personal rooms for patients
- Telephones, clocks and documents with larger print
- Blankets warmed in ovens
- Equipment to aid in hearing/communication between patient and health professional
What if families are far away? Teleconferences with families need to be immediately available. It is possible that Dad or Grandad has chosen to hide his medical condition from his family. This is his decision, but staff are there to explain and prepare him for what lies ahead as his illness progresses. Plans need to be made for caregivers if he needs help.
The idea of self-contained "Senior Emergency Medicine Clinics" seems feasible and necessary. If this is not enacted, those 65 and over will impede the flow of the typical ED and cause the ED's to reach capacity with regularity. The solution is as simple as a re-direction of the group to a more resourceful staff at a facility built specifically for their needs.
According to the Wall Street Journal, the good news is that more than 50 geriatric emergency departments have earned the Geriatric Emergency Department Accreditation (GEDA) and 100 more ED's are in the process of accreditation.