Emergency Geriatrics

As our population ages, the Section of Emergency Geriatrics is dedicated to meeting the acute and critical needs of older patients with informed and multidisciplinary emergency care and an educated and prepared workforce.

Both of our clinical sites have been recognized by the American College of Emergency Physicians with Level III Geriatric Emergency Department Accreditation (GEDA). In 2019 Memorial Hermann –TMC became the 1st Accredited Geriatric the Emergency Department in Houston (and LBJ the 2nd of 3), and 2nd in the State of Texas, Each Department’s GEDA received support from the UTHealth Houston Consortium on Aging and the Wyatt Ranches Foundation. Our approach follows the Institute for Healthcare Improvement’s 4 M’s model for Age-Friendly Health Systems (AFHS) – Mobility, Medications, Mentation, and what Matters to the patient, whether that means full intensive treatment or palliative care, and we are actively pursuing AFHS designation at both sites. In all cases, we strive to maximize quality of life and the greatest independent life as safely possible.

Our geriatric-specific programs are both simple and complex, but each is impactful. We screen for hearing impairment and give away free hearing amplifiers (“over-the-counter hearing aids”) to hard-of-hearing patients in order to improve clinical communication, decrease unnecessary cognitive load, and help prevent hospital delirium. With support from grants from the John A. Hartford Foundation, LBJ’s Emergency Center is 1 of 5 sites in the country to develop, pilot, and now disseminate to other institutions a rapid process for screening and intervening during the Emergency Department visit for elder abuse and neglect using the National Collaboratory to Address Elder Mistreatment’s Elder Mistreatment Screening and Response Tools (EM-SART). And Memorial Hermann – TMC, the country’s busiest Level I trauma center we are innovating the early use of ultrasound on every geriatric Level I and Level II trauma patient in order to identify, and then address cases of occult hypoperfusion and reduce elderly patient’s downstream mortality. Many of these patients are managed by specialized Geriatric Trauma Hospitalist Service, under the auspices of the Department of Emergency Medicine.

Highlights:

  • Two Accredited Geriatric Emergency Departments
  • Trauma assessment and management protocols targeting the unique features of geriatric trauma patients
  • Lighthouse multidisciplinary screening for and intervention in Elder Mistreatment in the Emergency Department
  • Protocols and resources to improve communication and understanding for hard-of-hearing patients
  • Collaboration and grant funding from regional and national foundations
  • Director’s endowment as Wyatt Ranches Distinguished Professor in Geriatric and Palliative Medicine