lder Americans account for nearly 13% of the population, over 1/3 of all hospital admissions, and approximately one-half of all hospital charges. In the next 40 years, the proportion of older people is expected to double. When an older person is admitted to a hospital, the acute problems that brought them there usually get better. But, there is often a functional decline associated with the hospital stay, such as disorientation and lack of mobility. Fully one-half of all disability that older people experience is associated with being hospitalized. To meet the challenges of our aging population, the San Francisco General Hospital and Trauma Center (SFGH) has developed an Acute Care for Elders (ACE) unit, a geriatric-specific model of care for older patients that require hospitalization.
The ACE unit is a physical space within the medical center and features a geriatric-friendly environment that is focused on safety, management of geriatric syndromes, and prevention of the loss of physical and mental abilities. The unit enables older hospitalized adults to recover in an environment prepared with their special needs in mind. The focus of the unit is to maintain physical and cognitive function.
The unit creates a homelike setting with uncluttered hallways and rooms and a peaceful quiet zone for patients and visitors. Everything from low-glare flooring and a warm color palette to a common dining area is designed to promote mobility and socialization, two cornerstones of recovery for the elderly patient. Simple activities such as enjoying the fresh air and sunshine on the unit’s patio can mitigate depression as does eating in a communal dining room. Improving mobility is high on the priority list as it makes it easier for a patient to return to their own home rather than a nursing home.
The success of the ACE program is based on the expertise of the interdisciplinary care giving team. The ACE team includes an advanced practical nurse, a social worker, a nutritionist, an occupational therapist, a pharmacist, and a medical doctor collaborating to create an individualized care plan to improve patients’ mobility, reduce depression, and maximizes overall satisfaction. All members bring their expertise in working with older adults to the team and continue to receive special training. The team meets daily to review and plan care for all patients, including nursing care and rehabilitation. Their efforts help patients make smooth transitions from hospital to home life. Caregivers involve the patient’s family members early in the process, helping them anticipate social needs, and offering solutions to problems they may foresee.
The ACE model has been proven to increase patient and staff satisfaction, and most importantly, affect the older adult’s quality of life in a positive manner through its coordinated holistic approach.
