Special training helps Emergency Department treat geriatric patients

For the Miami Valley Today

TROY — When Gilbert Miller visited the Upper Valley Medical Center (UVMC) Emergency Department for a severe headache and problems with his eyes, he received treatment from a specially trained team with expertise to pick out nuances specific to the geriatric population and recognize signs and symptoms of stroke.

A Piqua resident, Miller, 76, came to the emergency department at the urging of his daughter, Penny Miller.

“She pushed me into going,” he said.

He wasn’t aware of the extra training the staff had undergone to prepare for patients like him, but he was pleased with the care he received.

“When I walked in there, they just took me away. There were the nurses, doctors. They ran tests, X-rays to try to find out what caused this,” Miller said. “The whole time, somebody was asking me if I was all right. It made me feel good, they cared about me and my problem.”

Miller was impressed that he received calls from the hospital after his visit to see if he was seeking follow up care for what was diagnosed as a minor stroke.

“I was treated well. I respected that. My daughter and I talked about it for days, the way I was treated,” he said.

The Vietnam veteran said he continues to see specialists through his visits with the Veterans Administration as they work to determine the source of his headaches and the crossing of his eyes for around 30 minutes.

The UVMC Emergency Department was the first in Miami County with an American College of Emergency Physicians Geriatric Emergency Department Accreditation. The designation, which dates to 2020, requires not only enhanced staff education but also senior-friendly equipment.

“The education required to receive this accreditation highlights the physiological changes associated with aging and focuses on how illness and injury may present in unique ways in this group,” said April Anderson, MD, MPH, emergency department medical director at UVMC.

Noting that people often say that children are not just smaller adults, Anderson said that also is true for seniors.

They “are not just ‘older adults.” Multiple differences exist in the cardiovascular, respiratory, immune, and nervous systems that can make diagnosing and treating illness tricky without the proper knowledge base, Anderson said.

Sarah Coe, a clinical nurse in the ED, holds degree in gerontology, the study of the aging process including the biological, psychological, and sociological aspects of aging and old age.

This accreditation bolsters the quality of care for the geriatric population by enhanced staffing and education, geriatric-focused policies, and protocols (including transitions of care), quality improvement and metrics, and a more prepared physical environment, Coe said.

“The staff at Upper Valley Medical Center understand the unique needs of geriatric patients. In our facility we offer walkers for patient use, bed alarms for safety, care managers to assist with setting up home health care and nursing home admissions, and much more. Our goal is to ensure that our staff is providing exceptional care for our elderly population,” she said.

Among issues caregivers would look for in a geriatric patient would be age-related changes in vision and hearing along with expected changes in kidney function and lung capacity. Medication lists would be reviewed to check for possible side effects, which are seen more often in the elderly. Social factors also come into play such as ensuring the patient’s support system of family or friends are involved early in the care.

UVMC recently earned Advanced Certification as a Primary Stroke Center from the Joint Commission based on continuous compliance with stringent stroke program performance standards and received the American Heart Association and American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award.