New 'GEM' Unit at Monmouth Medical Center Caters to Special Needs of Elderly ER Patients

With the aging population and the demographic shift of older adults in the health care system, emergency departments are increasingly challenged with the complexities of providing care for geriatric patients.

Estimates are that by 2030, one in five Americans will be 65 or older, and, while the aging of the U.S. population will impact all areas of health care, emergency departments in particular will be affected.  In response, Monmouth Medical Center will introduce a dedicated Geriatric Emergency Medicine (GEM) unit to better meet the complexities of providing care to this vulnerable geriatric patient population.

The new GEM unit at Monmouth Medical Center, which debuted in November, features six private enclosed rooms in a separate area of the hospital’s Emergency Department specially designed to meet the complex needs of the frail elderly and their caretakers.

“The environment is specifically designed for privacy and quiet and to reduce anxiety, noise, confusion and risk of falling,” says Catherine Hanlon, M.D., chair of emergency medicine at Monmouth, who notes that the nursing station in the center of the unit also was specially designed to increase visibility. “The rooms are attuned to special age-related needs with wall sconces that can be dimmed to provide a more relaxing environment and floor lighting that reflects to prevent falls.”

Other amenities of the unit include special beds with extra-padded mattresses to help reduce pressure and equipped with alarms to prevent patient falls by alerting staff if a disoriented patient attempts to get out of bed. Large face clocks, special pillow speakers to make watching television and listening to music more comfortable, and blanket warmers are among the host of amenities for the new unit.

“The physician and nursing staff have been specially trained and are dedicated to caring for seniors, and Angela Soldivieri, a nurse practitioner trained in geriatrics, is our program coordinator and will be in close communication with the referring physician,” Dr. Hanlon says, adding that all patients 65 and older will be screened for a host of risk factors and, if appropriate, will be admitted directly to the GEM unit. “The unit also has a dedicated pharmacist who will focus on medications commonly prescribed for seniors with special attention to issues that can result in dangerous interactions.

“The discharge process begins in the ED with continuity and coordination of care throughout Monmouth Medical Center, as well as with community providers, agency staff and nursing home staff as appropriate,” she adds.  “The goal is for the transition to be seamless and to decrease the possibility of a return visit to the ED.”

Jessica Israel, M.D., chief of geriatrics and palliative care at Monmouth Medical Center, notes that the GEM Unit is the latest in a host of initiatives taken by Monmouth to meet the special needs of its elderly patients.

She points to Monmouth Medical Center’s longstanding and comprehensive geriatric program, which coordinates health and social services for the elderly and their families with a focus on comprehensive care and education. Monmouth’s Anna Greenwall Geriatric Program — which is led by geriatrician Priya Angi, M.D., specializes in medical care for the older adult, assessment of memory disorders and support for caregivers and the health professional, through a network of hospital-based and community-based services.

In addition, Monmouth Medical Center will be the lead hospital in the Barnabas Health Transition Program for the Frail Elderly with Dementia, a program designed to improve patients’ self-management of their care and decrease hospital readmissions among this vulnerable population afflicted with multiple chronic health conditions. The program is funded through a Robert Wood-Johnson Foundation grant awarded to Barnabas Health Fondation, and will be developed and initiated at Monmouth Medical Center under Project Director Allan Tunkel, M.D., chairman of the Department of Medicine at Monmouth, and then expanded to other Barnabas Health affiliates throughout New Jersey.

To learn more about the GEM unit at Monmouth Medical Center, call 732-923-6740. To learn about other programs or service for seniors, call 888-724-7123.