By Kristen Batchelder, MPA
They aren’t always the most glamorous calls. They aren’t the ones that get your adrenaline pumping or allow you to call upon your extensive training in emergency response. Instead, it’s the call for the elderly man who is wandering in the woods in the winter without a coat or shoes. It’s the call for the 90-year-old woman who refuses to go to the hospital because she believes her young children are coming home from school any minute. It’s the call for a combative nursing home resident who has been kicking and biting the staff who were trying to provide personal care.
These are the situations that sometimes seem to defy our training and our logic. These are situations that we often find ourselves surprisingly unprepared to manage.
However, with almost one out of every five Americans reaching the age of 65 and older by 2030, we need to recognize that these
calls will increase in frequency and we must be proactive in learning how to manage them. The face of EMS is changing at the hands of the aging Baby Boomers and, as an industry, we need to be ready to respond to these types of issues as well as the more typical medical and functional problems that prompt our elderly neighbors to call 911.
Have you ever stopped to think about the day-to-day experience of the elderly person? How that day-to-day experience could affect their physical functioning and emotional well-being? How it can affect their response to you as a firefighter or EMT, and how your response might need to be modified in order to provide the best possible care?
Our geriatric population is experiencing a host of physiological and psychosocial changes as part of the normal aging process,
even in the absence of chronic disease. These changes, frequently coupled with comorbidities, mean that there must be a paradigm shift in the way that we interact with and treat the elderly in an emergency setting, not only to ensure the provision of excellent care, but also to improve the efficiency and effectiveness of the care delivery system. One such comorbidity is Alzheimer’s disease – an epidemic plaguing the United States. Therefore, skills such as communication techniques and understanding and managing difficult behaviors associated with Alzheimer’s disease will become some of the most important tools of the trade, just as valuable as anything else we might carry on our rigs.
As the elderly population in New York State continues to grow, pre-hospital care providers will also have an increasingly important role in ensuring the health and safety of elderly members of the community even outside of the confines of the emergency call. First responders have a unique advantage that physicians, hospital social workers and many case managers do not have the ability to see a person’s living environment.
Understanding community support structures, available services for the elderly and knowing what to look for in an elderly person’s home to help determine if it is a safe and healthy setting are important components of geriatric pre-hospital care. The benefits of this often prove to be two-fold: It allows elderly members of the community to receive the services they need to help them function well and it also often reduces the strain on your organization by reducing non-emergency calls related more to loneliness or inability to independently manage activities of daily living than an actual medical emergency.
Clearly, a solid background in geriatric care can provide you with a wealth of techniques that can have a significant impact on your ability to provide excellent and efficient care, to positively impact the life of the elderly members of your community and even reduce some of the strains on your volunteer responders.
The first time you use a simple technique in the field to manage a difficult behavior and see almost immediate results, you too will start to realize that geriatric care can actually be one of the most interesting – and satisfying – components of pre-hospital care.
A senior care expert and current partner/chief operating officer of ICC Management and Consulting in Albany, Kristen Batchelder will present “The Graying of America” at FASNY’s Emergency Medical Service Conference January 31 in Selden and EMS
Seminar March 7 and 8 in Montour Falls.