Special Hospital Unit Prevents Mental and Physical Decline in Elderly Patients
SAN FRANCISCO –“Mom just isn’t the same since she came home from the hospital.”
Wendy Zachary, M.D., a geriatrician with Sutter Health’s California Pacific Medical Center in San Francisco, used to hear this complaint often. But since launching the volunteer-powered Hospital Elder Life Program (HELP), her patients are safely going home sooner, are readmitted less frequently and suffer fewer falls.
Dr. Zachary and her team opened an Acute Care for the Elderly (ACE) unit at the new CPMC Mission Bernal Campus hospital in August, building upon the success of the HELP program at CPMC’s Davies and Pacific campuses. Mission Bernal’s ACE unit is the first one of its kind for Sutter Health and one of only about 200 nationwide.
Nationally, ACE units have a proven, two-decade success record of helping decrease incidents of hospital complications like delirium, bring down costs, decrease length of hospital stays, improve coordination and mobility and reduce readmissions. This is critical because elderly hospitalized patients are prone to suffering delirium –which, according to Dr. Zachary, has the same risk of mortality as a heart attack.
“We know when geriatric patients are located in the same area of the hospital, such as in an ACE unit, they get better care,” says Dr. Zachary. “This is because the care providers see similar issues over and over, and the more cases you see, the more comfortable you become treating these patients.”
Mission Bernal’s ACE unit offers 19 patient beds, an activity room and a specialized physical therapy room—and staff and volunteers that are specially trained to care for older patients through the HELP program.
HELP volunteers provide elderly hospitalized patients with a personalized care plan tailored to help them stay mobile, remain socially engaged and prevent functional decline. These specially trained and vetted volunteers work one-on-one with patients at three CPMC campuses (Davies, Pacific and Mission Bernal). The volunteers get patients up and moving and encourage them to participate in activities and conversation, alongside a multidisciplinary team of doctors, nurses, social workers, case managers, physical and occupational therapists, a registered dietician and a pharmacist.
Patients’ care plans are created with special care. For example, medications are carefully reviewed and a senior’s normal sleep patterns are respected when scheduling procedures and planning medication administration.
“We don’t want to wake patients to give them medications, because this can disturb sleep patterns and contribute to delirium,” says Dr. Zachary. “So we take the time to understand each patient’s routine and schedule medications for when they are normally awake.”
HELP volunteers receive many hours of classroom and proctored training before they are allowed to work one on one with patients, according to ACE Unit HELP volunteer coordinator, Clara Rubin-Smith. “Our volunteers come to us from many walks of life, including retired nurses as well as those just starting out in their careers who plan to attend nursing or medical school. All share a passion for working with elderly patients,” says Rubin-Smith.
Developing better ways to care for elderly hospitalized patients is critical because the aging baby boomer generation coupled with longer life expectancies means that by 2030, California’s population of people over the age of 65 will be 8.9 million. Older people who are hospitalized for common reasons such as fall-related injuries, heart failure, dementia or dehydration often suffer delirium while hospitalized and they may return home “not quite the same.”
“A big part of the Mission Bernal story is that it’s a community hospital with its own personality,” says Dr. Zachary. “People who work there are welcoming and kind. They care. You can’t teach that. And that’s why the ACE program is a good fit. This is a good opportunity for older patients and their families to see how much Mission Bernal has to offer in care.”