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Emergency rooms designed for the older set

Will Turner, 94, has never had an emergency room experience quite like this.

At Mount Sinai Hospital in New York City, he found thick mattresses to prevent bedsores, skid-proof floors, and curtains designed to produce less noise. It’s only a few examples of the features designed specifically for senior citizens. 

“This is very far from the tumultuous feeling you have in other emergency rooms,” Turner said. “The others, there’s clatter going on, there’s litter, and people walk by who never look in your direction to see if you need something. This is different.”

According to the Centers for Disease Control and Prevention, individuals 65 years and older typically make up nearly 25 percent of adult emergency room visits. The creation of the geriatric centered emergency department, or geri-ed, at Mount Sinai Hospital represents a shift towards catering to the health needs of the growing aging population. 

Mount Sinai’s geri-ed follows the opening of a similar one at St. Joseph’s Regional Medical Center in Paterson, N.J., three years ago. More than 50 such departments will be opening in the health care system’s hospitals from New Jersey to California, according to Dr. Mark Rosenberg, the chief of geriatric emergency medicine at St. Joseph's.  Rosenberg, who also serves as chairman of the American College of Emergency Medicine's (ACEP) geriatric section, has assisted many efforts to build geriatric emergency departments, from hospital systems to emergency medicine management groups.

“I predict that hundreds of ED’s will move in this direction over the next several years,” Rosenberg said.

Since the creation of Mount Sinai’s unit on Feb. 17, older patients coming to the general emergency room are moved to the geri-ed, as long as they meet a certain number of clinical criteria, such as ability to remember their names or not needing resuscitation. In each of the eight bedrooms and six exam rooms, patients experience a quieter and calmer setting where they can wait and receive care from professionals specially trained in elderly care.

Dr. Kevin Baumlin, the vice chairman of emergency medicine at Mount Sinai, received inspiration for this facility from personal experience, when his grandmother broke her pelvis and was sent to a regular emergency room.

“It was really frustrating that no one seemed to be paying attention to her, that she was kind of lost in the shuffle,” he said.

Baumlin noticed the discrepancy – pediatric emergency departments have bright primary colors, toys, and child specialists tailored towards younger patients, but nothing similar existed for the elderly, who have equally specific needs.

The geriatric emergency department Baumlin spearheaded was designed with the intention of creating a safer and calmer atmosphere for the older demographic, he said. An example of the attention to detail is highlighted by the installation of fake skylights in the unit. Elderly patients, especially if they have dementia, tend to become confused in general emergency rooms that are brightly lit 24 hours a day. The Mount Sinai geri-ed is outfitted with skylights that tell elderly brains what time of day it is, and helps them adjust their body’s sleep and wake patterns.

A unique feature of the geri-ed is what Baumlin calls the geriPad – iPads that allow the patient and nurse to videochat for clinical needs. Requesting juice or food is as easy as a touch of a button on the screen.

Response to the new unit has been positive, and patient satisfaction ratings have been very high.

Turner is one of those satisfied customers. “I’m overwhelmed at the interest, the warmth and the service at this emergency room,” he said. “This is an extraordinary experience.”

Michelle Melnick contributed to this report.