Search the Health Library
Get the facts on diseases, conditions, tests and procedures.
I Want To...
Find a Doctor
Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians.
I Want To...
Find Research Faculty
Enter the last name, specialty or keyword for your search below.
Dome - What seniors deserve
What seniors deserve
Date: December 16, 2011
An 87-year-old widow is partially blind due to cataracts, is hard of hearing and has congestive heart failure, and she is admitted at a busy hospital. Her son lives 400 miles away and she has no other relatives close by. The R.N. assigned to take care of her has four other patients and quickly realizes that this new patient needs her help just to eat her breakfast. She can’t hear her nurse’s instructions or tell which medication is which, and there’s no family member available to help her.
Scenes like this take place every day because approximately 50 percent of hospitalized patients in the United States are age 65 and over. At Sibley Memorial and Suburban Hospitals, adults ages 85 and older make up almost 20 percent of the patient population. This percentage will increase considerably over the next 30 years.
Last summer, in light of these demographics and to improve elder care, Sibley and Suburban enrolled in the NICHE (Nurses Improving Care for Healthsystem Elders) program run by the Hartford Institute for Geriatric Nursing at New York University College of Nursing.
The program required each hospital to assemble a leadership team to develop multiyear plans for training staff and making improvements on units with older patients. After a two-month process, both institutions received the NICHE designation. Hospitals that achieve this are widely recognized as being geriatric-sensitive organizations committed to bettering the care of elders.
Such basic changes as replacing difficult-to-see clear straws with red ones on meal trays, installing telephones with large numbers, and painting hallways and bathrooms with contrasting colors to help patients differentiate walls from floors are already making a big difference in how elderly people manage during a hospital stay. “Simple additions like these can improve the inpatient experience of older patients, says Suburban nurse Denise Carlson, who directs the hospital’s adult medical unit. “Even patients with dementia are now active. We have them playing cards and using exercise balls.”
Health care providers at Sibley and Suburban are receiving sensitivity training to become more attuned to the needs of geriatric patients. For example, staff are asked to try on eyeglasses that simulate cataracts and ear plugs that reduce hearing, giving them some inkling of how hard it is to follow instructions, identify food and distinguish medications.
“Staff awareness is critical. NICHE has helped us to become aware of the very real difference between the needs of a hospitalized 40-year-old versus an 80-year-old,” says Susan Ohnmacht, Sibley’s associate chief nursing officer and director of critical care. By adopting the NICHE principles of care for older adults, health care providers are better able to identify and meet their patients’ needs while preserving their dignity and quality of life.
—Debra Scheinberg and Tiffany Payne