Great-Grandma May Not Like the Emergency Room

Emergency Departments (E.D.) were never intended to treat the elderly. They were not designed to cater to the complex slow evolving medical needs of the geriatric patient. Everything about an E.D. Is counter-intuitive to the treatment of the elderly. From the bright white lighting to the quick chaotic pace of the staff. Emergency Departments were designed for the fast immediate care of the acutely ill and injured.

When a geriatric patient arrives at the E.D. They are rapidly assessed by a triage nurse. Sometimes the medical issues plaguing the elderly are too complex to be relayed to the triage nurse in the short amount of time allotted.

Once the patient is brought back to a room, nurses, doctor's, and ancillary personnel feel frustrated because of the possibility of communication difficulty. The patient may not hear well, the patient may not express himself well and the symptoms are, at times, vague. Then throw in newly arriving critically injured patients and the staff turns their attention to the trauma room.

Emergency departments here and all over the United States are fantastic at what they do best, treat the acutely ill and injured. When it comes to dealing with chronic slow evolving medical issues, emergency departments are not the best places for geriatric patients to go.

I guess you're expecting me to say that Urgent Care centers are the best place for the treatment of the geriatric patient. Well, it's not. Whether you decide to come to Our Urgent Care or any of the other private and hospital owned urgent cares, we are not the best for the elderly patient. The best place for geriatric patients is their primary care physician (PCP).

The PCP has the time to get to know the patient. The PCP has records of the patient's medication and health history. The PCP knows the patients family and knows whether or not the patient will be compliant with medications and treatment options. Most importantly, the PCP can chart improvement or setbacks from treatment regiments already introduced. Neither the emergency department physician or the urgent care physician have this information unless the patient comes out and tells them.

The PCP have their draw backs, too. PCPs don't always spend enough time with the patient or their family. Due to office overcrowding PCPs are pulled in many directions. Appointments are difficult to get on short notice so a viable alternative can be the urgent care center.

If the geriatric patient has a non-life threatening illness or injury and is acting appropriately with no mental status changes than an Urgent Care center can be another tool for patient and family to use. The benefits of going to an Urgent Care include: the registration process is much less stressful. The triage system is slower and more laid back. The design of urgent care centers help the geriatric patient feel more welcome and comfortable. Urgent care center's are less chaotic than an E.D. Most have softer lighting and more comfortable chairs. Most urgent care centers offer more time to the individual patient. The reporting software at urgent care centers have the capability to record a patient's medical history and medications. So similar to a PCP office, the urgent care provider can review patient history before going into the exam room and provide the best patient care relevant to the current illness or injury.

Finally, when elderly patients go to an urgent care center they can be assured of a continuity of care. This means that all x-rays, lab results and any physician findings will be sent to the primary care physician, if requested.

Emergency departments, primary care physicians and urgent care centers all have their place in the health care system. Knowing when to use each and knowing how to benefit from their strengths is half the battle. Do your homework, and remember doctors work for you. Don't be afraid to ask questions if there is something concerning your healthcare you don't understand.