Geriatric Day Hospitals
Geriatric day hospitals are community-based or hospital outpatient programs intended to prevent unnecessary emergency department visits, hospital admissions and nursing home admissions. Seniors face a multitude of intersecting challenges that can contribute to cognitive declines and loss of independence; some of these challenges can include social isolation, physical weakness, unsafe housing, chronic pain and medication interactions. Traditional medical specialists tend to focus on a single illness or area of concern and cannot always address a wide variety of intersectional issues effectively. Each senior has a unique circumstance, where several different factors can contribute to their overall wellness or cause marked declines. Geriatric day hospitals embrace a multidisciplinary approach to effectively address the health care needs of older individuals.
Comprehensive assessments are key to providing a quick, accurate diagnosis and creating a treatment plan. Geriatric syndromes are multifactorial conditions that occur in older adults. In an article published by the Canadian Geriatric Society Dr. Lorraine Peitsch and colleagues present evidence that suggests the complex, multidisciplinary approaches of geriatric day hospitals result in better patient outcomes, fewer hospital admissions and prolonged independent living outside of a nursing home or institution. A key feature of the success of such day hospitals is the fact that patients and their multidisciplinary care team are able to have face-to-face interactions, including goal-setting sessions and care plan reviews, because all necessary members of a care team operate out of the same location.
Day hospitals are not meant to replace the primary care that seniors may receive from their family doctor, rather they are designed to support the complex care of older persons in collaboration with primary care providers. They operate best within a conventional hospital or rehabilitation facility with space for family meetings, examinations, physical recreation and private counselling areas.
The people who stand to benefit the most from geriatric day hospitals are people aged 65 years and older who aren’t chronically ill but who are at risk of decline while living at home. Such individuals may be at risk of prolonged hospital visits, which could in turn result in further social or physical deterioration. According to the article published by the Canadian Geriatric Society, the ideal candidates for treatment at day hospitals exhibit problems in multiple areas, necessitating care under more than one discipline of medicine; they must be motivated to participate in their own rehabilitation and therapy and have good baseline energy and stamina levels. People who have low stamina, are nearing the end of life or have severe dementia or organ dysfunction are not good candidates for day hospitals.
Geriatric day hospitals are a form of outpatient, ambulatory care with a multidisciplinary team working together in one place to maximize function for vulnerable older adults in a community setting. Their goal is to minimize declines and maximize independence and function, while avoiding unnecessary hospital admissions and keeping patients living independently and safely at home.
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