By Annmarie Kaszubinski, BSN, RN, CEN
Because of the extensive number of retirees who reside in South Florida, 40% of our patients who come to the emergency department at Holy Cross Health in Fort Lauderdale are over the age of 65. By definition, these patients are considered geriatric. However, people are living longer and maintaining healthy, active lifestyles later in life than previous generations, so not every patient above this threshold will need as many accommodations as other patients in this age bracket do.
Something that is very common for elderly patients is the need for a catheter due to incontinence or mobility issues that prevent them from being able to get to the bathroom or use a bedside commode. However, we found that patients were developing infections due to the use of Foley catheters because their skin was not being kept dry and urine with bacteria was making contact with the skin for extended periods of time.
When I was working with emergency medicine physician John P. Cunha, D.O. during the Geriatric Emergency Department Accreditation process, we discovered the new and improved PureWick catheter for women, which is an external device that keeps urine off the skin, and a condom catheter for men. This helps to prevent patients from developing further complications such as infections.
The American College of Emergency Physicians oversees the Geriatric Emergency Department Accreditation process. Holy Cross Health has been certified for four years and our current accreditation runs through August 2025, at which point we will apply for recertification. The Holy Cross Health nursing staff and emergency physicians work together to apply for this credential to give us credibility from an esteemed organization. In the application process, we must show what we have in place to provide elderly patients with the highest level of care. For example, we have walkers, bedside commodes and other assistive equipment to help patients who have mobility issues.
This distinction builds trust in our community that Holy Cross Health is the local hospital of choice for Broward County residents. Our medical team is specially trained to communicate with the elderly population by exuding patience and knowing how to handle patients who have hearing impairment, memory issues, cognitive issues, delayed response time, confusion and other conditions that often come with advanced age. The staff also listens to and acknowledges the patients’ input, as well as welcomes the opinions and questions of family members.
Holy Cross Health’s learning system, HealthStream, provides ongoing education to keep medical staff up to date on the latest trends, treatments and products. Each nurse is expected to complete courses through the platform annually, some of which are dedicated solely to elder care. Twice a year, Holy Cross Health hosts in-person skills fairs with training sessions and demonstrations of new equipment or to brush up on existing treatments.
News headlines also contribute to the latest trends in elder care. More patients are inquiring about not only COVID-19 vaccines, but also RSV and shingles. We work with them to make sure they are up to date on their vaccines to help keep them healthy.
The other headline that has gotten people talking is actor Bruce Willis’ diagnosis of frontotemporal dementia. When people with notoriety bravely come forward and openly discuss a medical diagnosis, it makes it less taboo. The general population becomes more comfortable discussing it too, rather than brushing it under the rug or living in denial. Of course, celebrities and non-celebrities deserve the right to keep their medical conditions private, but we praise the Willis family and other famous families for sharing their stories because it truly is making a difference in helping seniors get the care they need because they are being more honest and transparent about their symptoms.
At Holy Cross Health, our primary goal is to enable seniors to maintain their independence, live in the comfort of their home environment and stay out of the hospital for as long as possible.
Annmarie Kaszubinski is Nurse Manager, Emergency Department at Holy Cross Health.
