Elderly patients who visit the Emergency Department at The Scarborough Hospital can probably expect a visit by Nurse Practitioner Debbie Driver (General campus) or Clinical Nurse Specialist Elaine Laine (Birchmount campus), who specialize in geriatric care.

They represent GEM (Geriatric Emergency Management), an initiative aimed at reducing Emergency wait times and enhancing health outcomes for seniors. The program delivers targeted geriatric assessments and interventions to high-risk seniors aged 75 and older who present to the Emergency.

“As a Nurse Practitioner, I order certain diagnostic tests and write prescriptions, which frees up other nurses and physicians to look after more patients,” Debbie explains. “I have the luxury of spending more time with the patient to conduct a more thorough assessment as to why the patient is in Emerg in the first place.”

While seniors may present with one chief complaint, Debbie and Elaine are able to fully assess patients to determine other co-morbidities that may have brought them to the Emergency Department  in the first place.

“If Aunt Sally broke her ankle, was it because her blood pressure medication has been changed? Maybe her eyesight is failing. There could be 64 other reasons why she broke her ankle,” Debbie adds.

In so doing, Debbie and Elaine can work with patients and their families in ensuring the elderly are safe to go home.

“We try to cut off adverse outcomes that will prevent them from havin g to return to the Emergency at a future date. We can redirect unnecessary admissions, collaborate with long-term care facilities, outreach Nurse Practitioners and home care personnel to avert further Emergency  Department transfers,” Debbie adds.

MULTIDISCIPLINARY REFERRALS

“Patients are often referred to us electronically by Emergency staff and physicians,” Elaine says. “GEM is well received because it saves the primary Emergency nurses from doing the legwork. We work with social workers, the Geriatric Specialty Clinics (at both campuses), other geriatric specialists and the local CCACs to ensure it is safe for the patient to return to their homes.”

With 25 per cent of all patients visiting TSH’s Emergency Department aged 65 and older, “we’re seeing the trend that shows baby-boomers are aging and living longer,” Elaine adds. “The rising numbers of seniors coming to the Emergency Department will naturally have an impact on wait times. GEM works to address these challenges.”