Elder-Specific Hospital Wards Can Prevent Decline and Save Money
Nearly 13 million seniors are hospitalized each year. That’s a big number – but what’s worse is that many of these patients will suffer lasting damage from their hospital stay. That’s because most hospitals are not designed with the needs of seniors in mind. But a relatively small number of pioneering hospitals is changing that, and the results seem extremely promising. That’s the conclusion from a recent article on National Public Radio, described in a story called “Hospital Units Tailored to Older Patients Can Help Prevent Decline.” We urge you to click here to read this important article, one which could be a life-saver for you or a loved one facing future hospitalization.
The NPR article focuses on a hospital in San Francisco with what they call an ACE Ward, one of only about 200 nationwide. ACE stands for “Acute Care for the Elderly.” As NPR puts it, “Patients over 65 tend to be less resilient during a hospital stint than younger patients, research finds, and more vulnerable to mental or physical deterioration, even if they recover from the illness or injury that sent them there.” The tragic outcome is sobering, says NPR. “One study published in 2011 found that about a third of patients older than 70 and more than half of patients over 85 left the hospital more disabled than when they arrived.”
Why is this? What’s the cause of this dramatic drop in well-being among the most senior patients in hospitals? NPR quotes San Francisco physician Dr. Ken Covinsky: “A lot of the stuff we do in medicine does more harm than good,” he says. Often the cause of a patient’s decline is not actual neglect, but rather failure to take the special needs of senior patients into account.
For example, in meal planning, many hospitals fail to ensure that senior patients get sufficient nutrition. They may unintentionally fail to properly monitor elders for drug reactions or pain management. Hospitals also make a practice of checking up on patients at all hours of the day and night, interrupting sleep, which can affect seniors disproportionately. A huge problem is protracted bed rest, which can pose a major health challenge for senior adults, setting off what one doctor called “an explosive chain of events” that can harm a senior’s health permanently.
“And if the drug side-effects, interrupted sleep, unappetizing food and long days in bed are annoying when we’re young, they can cause lasting damage as we get older,” says NPR. The needs of senior patients are so particular and unique that some hospitals like the one in San Francisco have begun establishing separate medical units to treat elderly patients. But because space in these wards is often limited, too few seniors are receiving the proper type of care.
Here’s another aspect of this medical crisis that we found outrageous. NPR quotes Dr. Covinsky as stating that “hospitals face few consequences if elderly patients become more impaired or less functional during their stay.” The federal government penalizes hospitals for a variety of outcomes – falls, preventable infections, or return admissions within 30 days. “But the institutions aren’t held accountable if patients lose their memory while there or become so weak they can’t walk,” says NPR. “As a result, most hospitals don’t measure those things. ‘If you don’t measure it, you can’t fix it,’ Covinsky says.”
One final note on this topic: with all the emphasis on health care costs these days, wouldn’t these special acute care wards for seniors cost more? On the contrary, NPR says. “The extra investment needed to create specialized units would pay off in the long run, for patients, hospitals and for the U.S., as it works to bring down health care spending. ACE units have been shown to reduce hospital-inflicted disabilities in older patients, decrease lengths of stay and reduce the number of patients discharged to nursing homes. In one 2012 study published in the journal Health Affairs, researchers found that hospital units for the elderly saved about $1,000 per patient visit.” Clearly this is an idea whose time has come, we believe.
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(originally reported at www.npr.org)