Why should we have a ‘geriatric’ emergency department?

5922817362_8fd01d909b_oRosa McNamara is a consultant in emergency medicine in London, with a special interest in geriatric emergency medicine. She tweets @rosamcnamara

So we all know that the world is growing older – it is now common for emergency department (ED) clinicians to spend the majority of their day looking after frail older adults. In emergency medicine (EM) we are going through a longish period of reflection on how best to care for older adults (EM is just over 40 years old, and for 30 of those years there has been discussion about this). Interest in the needs of frail older adults has widened and many solutions have been tried in EDs worldwide, with mixed results. These include rapid response teams, liaison geriatrics, interface geriatrics and the development of seniors EDs.

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Acute care for older people

Dr Simon Conroy is Head of Geriatric Medicine, University Hospitals of Leicester, Honorary Senior Lecturer, University of Leicester and an Associate Editor for Age and Ageing journal.

Acute care for older people appears to be the topic de jour. The increasing number of older people attending acute care should not be a surprise given the demographic pressures, yet many hospitals still appear slightly taken aback by the increasing age, complexity and number of patients accessing urgent care.

A range of efforts to reduce hospital attendances do not appear to have attenuated the patterns over recent years. GPs are being performance managed on avoidable admission, emergency departments are beholden to the 4-hour wait and in-patient teams are hounded on a daily basis to discharge yet more patients.

Is there a better way? We hope so. At a forthcoming conference hosted by the Royal College of Physicians, we will bring together relevant stakeholders to share ideas and thoughts about how to make things better. Importantly the speakers represent all stages of the patient pathway.

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Innovative approach to care of the older patients celebrated in the Daily Mail

Following the Francis Report we ought to be taking every opportunity to highlight excellence and quality in Health Care of Older People being delivered across many NHS trusts. This article from the Daily Mail reports an innovative scheme from Nottingham.  It is an example of the sort of thing we ought to celebrate.  Click on the hyperlink above – I’ll let the article speak for itself.