Complexities of Diagnosing Older Adults

medical staff pushing an older adult on a gurney in a hospital

As we age, our health needs become more complex and there are challenges associated with diagnosing older adults accurately. Errors in diagnosis are relatively common among older people and this topic was recently highlighted by NPR.

Why Diagnosing Older Adults is Challenging

Older adults often have multiple health conditions and take various medications, which can make diagnosis tricky. Keeping an up-to-date list of medications can be vitally important, particularly in a health crisis. The Oldish has a medication list available to subscribers (subscriptions are free) in our Toolkit. It’s important to understand that any hospital visit, particularly one that is an emergency, can be confusing and upsetting leading to an inability to remember the details that could aid in timely diagnoses.

Illnesses might present differently in older people compared to younger individuals. For instance, symptoms that are obvious in younger patients might be subtle or absent in older adults. This complexity can lead to both under-treatment and over-treatment, potentially causing serious consequences.

A study from Johns Hopkins University highlights the gravity of this issue, revealing that nearly 800,000 Americans die or become permanently disabled each year due to diagnostic errors. This statistic underscores the urgent need for improved diagnostic processes, especially as the population of older adults continues to grow rapidly.

Innovative Solutions in Geriatric Care

Fortunately, more attention is being paid to effectively treating older adults in some facilities. For example, Glen Cove Hospital on Long Island has taken significant steps to cater to this demographic. At Glen Cove, a third of emergency room patients are over 65. To better serve them, the hospital’s emergency department is designed specifically for older adults, making it one of over 500 hospitals accredited as geriatric emergency departments by the American College of Emergency Physicians.

Enhancements for Safety and Comfort

In these specialized emergency departments, you’ll find numerous subtle enhancements aimed at safety and comfort. Instead of noisy cubicles with curtains, patients have private rooms with doors and frosted glass for privacy. The floors are textured to prevent slips, and ambient lighting replaces harsh fluorescent lights, reducing the risk of delirium, a common issue in older patients.

Communication tools are also crucial. For example, older patients may arrive without their glasses or hearing aids. Glen Cove provides assisted hearing devices that amplify the doctor’s voice, ensuring clear communication. These thoughtful touches transform the emergency department into a more welcoming and less stressful environment, which can significantly improve diagnostic accuracy.

The Need for More Geriatric Specialists

Dr. Patrick Coll from UConn Health emphasizes the importance of training more doctors in geriatrics. Despite the growing need, there are still far fewer geriatric specialists compared to other fields like cardiology. As the population of older adults grows, especially those over 85, we need more experts who understand the unique aspects of aging bodies and minds. Canada has 376 geriatricians while the US has 7,300 – fewer than one percent of all physicians.

Nurses as Key Players in Diagnosis

Nurses play a critical role in patient care, often spending more time with patients than doctors. Allie Tran, a senior research scientist at MedStar Health Research Institute, is working on a project to involve nurses more directly in the diagnostic process. Nurses can bridge the gap between patients and physicians, catching vital details that might otherwise be missed.

Advocating for Yourself

Older adults like Karla Stromberger, who is 80, often find themselves advocating for their own health. Stromberger, a retired physical therapist, had polio in the 1950s and faces ongoing health challenges related to that. She emphasizes the need for healthcare providers to look beyond age and consider each patient’s unique medical history. Family members should also be aware of their loved ones’ medical needs and be prepared to advocate.

Accurate diagnosis is the cornerstone of effective healthcare, and for older adults, it’s particularly vital. By creating environments tailored to their needs, training more geriatric specialists, and involving nurses more deeply in the diagnostic process, we can improve outcomes and ensure our older loved ones receive the care they deserve.