When 86-year-old Carol Wittwer took a taxi to the emergency room, she expected to be admitted to the hospital. She didn’t anticipate being asked if she cooks for herself. If she has friends in her high-rise. Or if she could spell lunch backward.
“H-C-N-U-L,” she said, ruling out a type of confusion called delirium for the geriatrics-trained nurse who was posing the questions in a special wing of Northwestern Memorial Hospital’s emergency department
Wittwer’s care is part of a new approach to older patients as U.S. emergency rooms adapt to serve the complex needs of a graying population. That means asking more questions, asking them earlier and, when possible, avoiding a hospital stay for many older patients.
The surprising truth? Hospitals can make older patients sicker. Infections, incontinence and weakening muscles from bed rest can cascade into delirium, frailty and death.