Treating geriatric patients in the emergency room a decade ago was barely discernible from treating any other patients. Doctors and nurses didn’t necessarily acknowledge the special needs of geriatric patients. Things have since changed. Thanks to the emerging specialty of geriatric emergency medicine, doctors are beginning to think of their older patients in more well-defined terms.
According to a July 29 Stanford Medicine report, geriatric emergency medicine is a relatively new specialty. It is a specialty that focuses on the unique needs of patients over the age of 65. It is one that seeks to reduce hospital admissions while still meeting patient needs in a comprehensive and caring way.
Geriatric Needs Differ
Stanford’s Dr. Nida Degesys says that geriatric patients are different from a clinical perspective. For starters, they often present disease differently than younger patients. Their bodies take longer to heal. Because of their age, geriatric patients don’t necessarily respond to treatment the same way as a younger patient would.
Degesys says that it can be more difficult to treat geriatric patients because they are more reluctant to be open. For example, although a patient might be experiencing pain after a fall, he/she might also be reluctant to say anything about it. The doctor is left to guess.
In terms of their specific needs, geriatric patients are more likely to injure themselves in falls. According to the CDC:
- 20% of falls result in serious injury
- 3 million seniors are treated in EDs for falls every year
- 800,000 seniors are hospitalized for injuries related to falls
- more than 95% of all hip fractures are the result of falling.
If falling and its subsequent injuries are not problematic enough, Degesys says that geriatric patients are at greater risk of complications from taking multiple prescriptions. Drug interactions can be very serious at times. It all adds up to a greater need for geriatric care that accounts for the differences of age.
Americans Are Getting Older
It’s not just a recognition of geriatric needs that is fueling the emerging geriatric emergency medicine specialty. There is also the knowledge that Americans are getting older. U.S. Census data shows that the number of Americans age 65 and older constituted 16% of the population in 2016, up 30% from 2010.
The medical field is experiencing the aging phenomenon firsthand. As the initial wave of baby boomers is now hitting retirement age, more and more older patients are winding up in the emergency department in need of care. And as America ages, the need for geriatric-specific care is only going to grow.
Adapting Care to Geriatric Needs
So what is so different about geriatric emergency medicine? All of the underlying medical principles remain the same, but clinicians learn to adapt their care to geriatric needs. Again, falls offer a great illustration.
A 20-year-old who comes to the emergency department after suffering a fall may genuinely only be dealing with a few minor abrasions and contusions. If she says she isn’t experiencing any unusual pain, the attending physician accepts that the moves on. Things are different with a 75-year-old.
You have to dig a little bit deeper when you’re treating geriatric patients. You have to account for the fact that hearing loss might be preventing the patient from fully grasping what you’re saying. Before that patient leaves the ED, you have to talk about things like mobility devices and how daily tasks are going to be performed during recovery.
Needless to say that geriatric emergency medicine is unique. It is an emerging specialty growing numbers of doctors are finding attractive.
