Lifestyle

In Search Of Age-Friendly Health Care, Finding Room For Improvement

Judith Graham

A month in the past, throughout a go to to her physician’s workplace in Sequim, Wash., Sue Christensen fell to her knees within the lavatory when her legs all of a sudden gave out.

The 74-year-old was in an accessible stall along with her walker, an older mannequin that doesn’t have brakes. On her left aspect was a seize bar; there was nothing to carry onto on the fitting.

Christensen tried to tug herself up however couldn’t. With problem, she rearranged her clothes and, inching ahead on her knees, exited the stall. There, she tried calling the entrance desk on her cellphone however was positioned on maintain by the automated cellphone system.

Altogether, Christensen, who has a herniated disk in her again, was on the ground for nearly half an hour earlier than a nurse and her husband, who’d been parking the automobile, lifted her to her ft.

“I just wish there had been a button that I could have pushed indicating that someone in the restroom needs assistance,” she stated.

For older adults, particularly those that are frail, who’ve impaired cognition, or who’ve hassle seeing, listening to and transferring round, well being care services might be troublesome to navigate and, sometimes, perilous.

Grab bars might not be positioned the place they’re wanted. Doors could also be too heavy to open simply. Chairs in ready rooms could lack arms that somebody can use to assist them get up.

Toilets could also be too low to rise from simply. Examination tables could also be too excessive to get onto. Lettering on indicators could also be too small to learn. And there might not be a spot to take a seat down whereas strolling down a hallway if a break is required.

“Most hospitals and clinics have been designed for 40- or 50-year-olds, not 70- or 80-year-olds,” stated Dr. Lee Ann Lindquist, chief of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago. “Additional thought has to be given to seniors who have functional disabilities.”

What modifications may very well be made to higher accommodate older adults’ wants? I requested geriatric specialists and seniors to determine sensible points that needs to be addressed. Here are quite a lot of solutions that got here up repeatedly.

Parking

Difficulties begin within the car parking zone, which might not be adjoining to the medical heart.

That’s the case at Long Island Jewish Medical Center, a big educating hospital in New Hyde Park, N.Y. Every day, Dr. Maria Torroella Carney, a geriatrician on the hospital, crosses a busy highway from the car parking zone to the hospital’s entrance.

“It’s challenging. There isn’t clear signage indicating where to cross safely, and if you need to stop and rest there aren’t any benches nearby,” stated Carney, who can also be chief of geriatrics at Hofstra/Northwell School of Medicine.

Dr. Michael Wasserman, a California geriatrician on the board of the American Geriatrics Society’s Health in Aging Foundation, noticed that accessible parking areas are sometimes briefly provide. “Even then, not all older adults who need help have a handicap sticker,” he famous.

The University of Florida’s Senior Care Clinic has an answer: valet providers. “When an older patient comes by themself, if they need help, the valet will call our clinic and someone will come down and take the patient up,” stated Dr. Bhanuprasad Sandesara, division chief of geriatrics.

Signage

All too usually, easy-to-read indicators indicating the place sufferers ought to go can’t be discovered, both inside or outdoors medical facilities. For older sufferers, this may result in confusion and pointless wandering, accompanied by ache, fatigue and annoyance.

Last yr, a committee inspecting how Long Island Jewish Medical Center ought to deal with sufferers with particular wants (as an illustration, folks with cognitive impairments or listening to or speech issues) recognized higher signage as a precedence.

Now, indicators within the car parking zone and outdoors the medical heart are larger, with bigger sort. Inside the medical heart, massive indicators have been positioned at loos, displaying clearly in the event that they’re accessible to these with disabilities. And the workers is making a complete map of the hospital campus — a handout — to assist sufferers discover their far more simply, in accordance with Roseanne O’Gara-Shubinsky, affiliate government director for high quality administration at Long Island Jewish.

Appointment playing cards had been additionally altered: Carney persuaded the hospital to print cellphone numbers in massive sort on playing cards for seven geriatricians at its senior clinic.

At Northwestern, Lindquist realized that older sufferers had been having hassle seeing whiteboards of their hospital rooms itemizing scheduled procedures and the names of physicians and nurses answerable for their care. Upon Lindquist’s urging, the hospital purchased whiteboards which can be greater than double the conventional dimension.

Getting Around

At a latest speak within the San Francisco Bay Area to advertise her new e book, “Elderhood,” Dr. Louise Aronson was approached by an older girl who makes use of a transportable oxygen tank to breathe and depends on a rollator walker (with a seat and basket connected).

The girl was new to the world and had been visiting varied medical services. “Some of these places have ramps, but the angle is so steep I can’t push my rollator up,” she complained. “Whoever designed them wasn’t thinking of someone like me.”

At the University of Arkansas for Medical Sciences, Dr. Jeanne Wei, who heads the geriatrics division and the Donald W. Reynolds Institute on Aging, has seen many older adults injure themselves whereas pushing somebody in a wheelchair up an incline. She has insisted that parking tons be on the identical stage as medical buildings and that sidewalks round services be stored in good condition to reduce older adults’ threat of falling.

Also, on the University of Arkansas’ Thomas and Lyon Longevity Clinic for older adults, examination tables are wider than normal and their top might be adjusted electronically. “Sometimes, it’s difficult to navigate lying in a narrow strip” and plenty of older adults are afraid of falling, Wei stated.

The workers at Long Island Jewish didn’t understand there weren’t sufficient walkers and wheelchairs on the hospital’s entrance till the problem got here to gentle throughout deliberations by the particular wants committee. Now, “we’ve made sure that we have plenty of these available,” O’Gara-Shubinsky stated.

Something so simple as having a hook to hold up a cane is usually a considerate contact. “You see this a lot: An older patient sits down, there’s nowhere to put a cane, and it falls on the floor,” stated Dr. Diana Anderson, a geriatric drugs fellow on the University of California-San Francisco, who’s additionally a board-certified architect.

Doors

Diane Ashkenaz, 68, has fibromyalgia, power ache and a ruptured tendon. She additionally has undergone two knee replacements. Most of the time, she makes use of a walker when she visits medical doctors within the Washington metropolitan space.

Doors are sometimes an issue. “Neither my primary care doctor nor my orthopedic surgeon have doors to their offices that open automatically,” Ashkenaz stated.

Not way back, she stated, the workers at a ache clinic’s entrance desk handed her a pen and clipboard and requested, “Can you fill this out please?” How was Ashkenaz supposed to carry these objects whereas discovering her strategy to a chair? No one appeared to appreciate there was an issue.

At the clinic Sue Christensen visits in Washington, the entrance doorways open extensive routinely and a nursing assistant helps her into the examination room. But as soon as her appointment is over, she’s directed to an exit door that she should open herself.

“It’s pretty heavy and hard to manage while trying to clunk my walker through,” Christensen stated. “I don’t know why they don’t have a door system that would be easier for people who don’t have much strength or dexterity.”

Seats

Ashkenaz has one other pet peeve: chairs in ready rooms with seats which can be too low or with out arms that she will seize to push herself up right into a standing place.

At her heart specialist’s workplace, there’s a settee with deep seats. “It looks nice, but I’d do anything not to sit there,” Ashkenaz stated. “I just can’t get up from it.”

Wei’s clinic on the University of Arkansas has introduced in chairs which can be four inches taller than normal, with arms, for older sufferers. “These chairs are always occupied,” she stated.

Also, examination rooms on the clinic are massive sufficient to accommodate chairs for a number of members of the family. “We’ll bring everyone in to talk about Mom or Dad so they can hear what the other person is saying,” Wei stated.

We’re keen to listen to from readers about questions you’d like answered, issues you’ve been having along with your care and recommendation you want in coping with the well being care system. Visit khn.org/columnists to submit your requests or solutions for a way medical services may grow to be extra age-friendly.

Kaiser Health News (KHN) is a nationwide well being coverage information service. It is an editorially unbiased program of the Henry J. Kaiser Family Foundation which isn’t affiliated with Kaiser Permanente.

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