An ER for Elderly Patients

A trip to an emergency room is no picnic no matter what your age, but for elderly adults, the noise, bright lights, and hard surfaces can be a hazard and contribute to an increased risk for falls leading to injury and for delirium – a common condition affecting older patients.  A $52 million dollar donation will help Toronto’s University Health Network develop an ER for seniors that will lead the way for others to create more emergency departments designed to support the needs of elderly adults. 

According to a recent Globe and Mail report, funding from the John and Myrna Daniels Charitable Foundation will help create a model for an emergency room designed around the specific need of frail seniors – the numbers of which are rapidly growing.  By accommodating for hearing and vision loss, frailty, and mobility issues, vulnerable seniors can be better cared for while in hospital.  Instead of raising voices for hard-of-hearing elderly patients, which increases noise throughout the department, a hand-held device with headphones can reduce the overall din while making sure seniors can hear and understand conversations with health care providers. 

Specialized glare-resistant flooring will help reduce the impact of falls, signage will be placed lower and more prominently, and bed rails will be lowered to make it easier for older patients to get in and out of bed.  By using neutral lighting, and reducing excess noise, incidents of delirium that can be serious or fatal for elderly adults in hospital are hoped to be lessened.  Delirium is common in hospitalized older adults – a third of general medical patients who are over 70 have delirium which can range from mild to severe and increase the risk of complications, a longer stay, a move to nursing care, and death. 

The new emergency department for seniors will also include in-unit occupational and physical therapy rooms resembling a home environment to better establish how a patient would function upon discharge.  This kind of assessment can improve outcomes for seniors, anticipate needed support, and help prevent a return to hospital. A dedicated compassionate care area will also be established to give families a quiet, comfortable space to gather with their loved ones at the end of life. 

The dedicated geriatric emergency department at UHN is scheduled to open in 2025, adjacent to the current ER at Toronto Western Hospital and will serve as a model for other hospitals across Canada for best practices in caring for elderly patients.