Why we need Geriatric ERs in Asia

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CNN (Source: Geriatric ERs reduce stress, risks for older patients – CNN.com) recently touched on the need for Geriatric emergency rooms (ER) that can provide seniors with better care. According to the world bank, in 2010 there were 211 million older adults 65 years and above in East Asia and even in a little island in Singapore, by 2020, 1 in 5 Singaporean will be an older Adult. We have hospitals for children across Asia, isn’t it about time we started having at least an ER for older adults? Wouldn’t this not only be beneficial to the patient and their family but beneficial to the outputs in terms of care and the cost to the system as well. We all know that hospitals are detrimental environments for older adults and especially so for people with dementia.

  • unfamiliar alien environment
  • difficulty in orientation
  • high levels of negative stimulation from noise, smell, temperature…
  • constant interruptions to sleep well into the night
  • lack of autonomy
  • lack of natural light

We also know the benefits for the patient if we improve the acute environment and the care provided, but there are also wider benefits for society and especially for the family. With dependency ratios increasing in Asia and higher life expectancy rates, think China, with 1.3 billion people and a 4,2,1 family structure. With 4 grandparents, a couple, and their child, and now with the removal of the one-child policy, you may have 2 children in the family. If an older adult has been admitted into the emergency room the stressors on the family, especially the working adult will be incredible. Anyone who is a parent and are caring for parents will know this. This is not inclusive of the 30 million bachelors in China who will be the sole caregiver of their parents. How can we have an effective workforce if there is a constant worry that our parents are not getting adequate medical care in hospitals, on top of juggling work, kids and worrying about the health of 3 other older adults in the family? As a child you can’t not worry about your parents especially when it involves the ER, it’s only natural. A parent going to the ER is possibly one of the scariest thing a child can experience. On top of that, there are the worries about the out of pocket cost for care. The least we could get really is a decent healthcare system that can help care for older adults, and a geriatric ER will be a good start. In a Geriatric ER at least we know our parents are getting the right care from the start and in the right environment, that in itself will be a great relief from the get go.

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We’ve all heard of the Chinese proverb:

“The superior doctor prevents sickness; The mediocre doctor attends to impending sickness; The inferior doctor treats actual sickness”.

A cultural change in care requires collaboration and evidence, and the success of early intervention will reduce the operational and financial strain on the health and social care system. Isn’t it time, for the hospitals in Asia that can make a change start doing something about it and adopt a salutogenic approach to care? Isn’t it time we start taking our own advice?

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