January 23, 2009

BIRMINGHAM, Ala. - UAB Highlands Hospital has created a specialized unit for geriatric patients, part of a comprehensive plan to anticipate and accommodate the health care needs of our aging population. The number of Americans over age 65 is expected to more than double, to 20 percent of the total population, between now and 2030.

The new Acute Care for Elders (ACE) Unit is designed with the needs of older patients in mind. While nursing and care staff have received advanced training in care of the frail older adult and special enrichment opportunities for patients are available in the unit, the centerpiece of the program is an interdisciplinary team approach that allows increased recognition and management of geriatric issues that often go unaddressed during a hospitalization.

Through daily meetings, the interdisciplinary team links a geriatrician and nurse practitioner in geriatrics to the patient's own nurse and attending physician. Health care professionals from every field that may have a role in treatment are represented, including physical and occupational therapists, respiratory therapists, dietitians, pharmacists, social workers, care managers, educators and volunteers.

"Treating an older adult who now requires hospitalization presents complications and challenges not seen in a younger population," said Kellie Flood, M.D., assistant professor in the Division of Gerontology, Geriatrics and Palliative Care at UAB and the medical director of the ACE Program. "It's been said that nowhere is the practice of medicine more art than science than in the care of older adults. The interdisciplinary team gives the attending physician access to health care professionals experienced and trained in recognizing the often subtle signs and symptoms associated with elder patients."

Geriatric patients being admitted for an acute illness often have co-existing conditions such as memory loss, functional decline and depression. They may be on multiple medications. These can adversely impact their hospitalization if not recognized and addressed. The daily team meetings help to increase recognition, while providing ongoing education for the staff.

For an older patient, simply staying in a hospital can lead to a decline in physical or cognitive ability. Working with the patient and family, the team seeks to establish a baseline of how much physical or cognitive function a patient had prior to hospitalization. Such baseline screening gives everyone involved - care team, patient and family - a goal to strive for after hospitalization, so patients regain as much of their former abilities and function as possible.

The unit also offers cognitive enrichment opportunities. Pet therapy from Hand-in-Paw is available, and music and art therapy are in the planning stages. The unit recently began "Wii-habilitation", using a Nintendo Wii gaming system to provide mental stimulation as well as a fun new method for physical and occupational therapy.

The ACE unit is home to the SPOONS program as well, utilizing volunteers at meal times to assist patients with eating, or to simply provide companionship, since many seniors have difficulty eating alone.

The ACE unit occupies 20 beds at UAB Highlands Hospital, following a growing trend in geriatric care across the country.

Those interested in contributing financially to support the unit's outreach programs should contact Virginia Gilbert Loftin, vgloftin@uab.edu or 205-975-5602.