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Published On September 28, 2017

CLINICAL CARE

Respect for Our Elders

Peter L. Slavin discusses the importance of giving older inpatients the proper care. 

The 1950s was an especially busy decade for obstetricians and midwives in the United States, peaking in 1957, the year when more babies were delivered than in any other in the nation’s history. Those babies are celebrating their 60th birthdays this year. While 60 may now be considered middle age—the new 50—the fact is that during the next four decades, the number of people age 65 and older in the United States will nearly double. More striking, the number of those 85 and older will more than triple, from 5.8 million now to 19 million.

The graying of baby boomers—those born between the mid-1940s and the early 1960s—represents a demographic transformation the likes of which our nation has never seen before. And with this rising wave of seniors comes a potential tsunami of age-related health issues that could strain our health care system clinically and financially unless we make significant changes in our approach to caring for the elderly.

In our story “Special Treatment,” Proto examines why those patients can be especially vulnerable while they’re in the hospital. Unfamiliar surroundings and physical frailty can make them more likely to fall and injure themselves. Irregular or interrupted sleep can trigger cognitive problems. In addition, hospital-acquired infections can pose a particularly dangerous risk for seniors.

Even as we work on innovations for avoiding hospitalizations in the first place, Massachusetts General Hospital is exploring ways to deliver better and safer care to older inpatients. Our Geriatric Inpatient Fracture Service (GIFTS), for example, treats seniors with broken bones, ensuring that they are seen quickly, stay in the hospital for as little time as necessary, and have their families included in care and recovery plans. Our full-service geriatrics medicine program collaborates closely with specialty programs in such areas as heart failure, memory disorders, neurodegenerative disease, rheumatology, depression and anxiety, and palliative care. We have also implemented a hospital-at-home program and mobile observation unit, in which physicians, nurse practitioners and others deliver inpatient-level care to certain patients in their homes. These days, too, telemedicine helps prevent some hospital stays and reduce the length of others.

We hope that the investments we make now to develop and implement new models of care for the elderly will have a meaningful impact on our health care system and the patients we will serve for generations to come

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