For the majority of us, aging will bring a host of physical challenges. Even a relatively healthy senior adult can have some difficulty walking, rising from a chair, or reading the small lettering on a sign, especially in busy public places. Unfortunately, some of those public places that should be designed with seniors in mind – health care facilities – turn out to be woefully inadequate, filled with thoughtless and even dangerous design elements that can make it challenging for older patients to come and go safely. In too many hospitals and doctor’s offices, age-friendly health care is an oxymoron.
Age-Friendly Health Care: Serving Seniors with Physical and Mental Limitations
The good news: many of the changes that can improve the safety of older patients are not that difficult or expensive to implement. That’s the point of this article we recently read on the Kaiser Health News website, written by frequent contributor Judith Graham. She writes, “For older adults, especially those who are frail, who have impaired cognition, or who have trouble seeing, hearing and moving around, health care facilities can be difficult to navigate and, occasionally, perilous.” The problems range from poorly-placed grab bars and doors that are heavy and hard to open, to waiting-room chairs that lack arms for support and toilets that are too low for frail seniors to use safely and comfortably. “Examination tables may be too high to get onto,” Graham continues. “Lettering on signs may be too small to read. And there may not be a place to sit down while walking down a hallway if a break is needed.”
In her Kaiser article, she cites a case from right here in the Pacific Northwest, when a senior patient was visiting her doctor’s office over in Sequim. While using the bathroom, her legs suddenly gave out and she fell to her knees, unable to rise. “The 74-year-old was in an accessible stall with her walker, an older model that doesn’t have brakes,” Graham writes. “On her left side was a grab bar; there was nothing to hold onto on the right.” Finally able to crawl out of the stall, “she tried calling the front desk on her cellphone but was placed on hold by the automated phone system. Altogether, [the patient], who has a herniated disk in her back, was on the floor for almost half an hour before a nurse and her husband, who’d been parking the car, lifted her to her feet.” The bathroom had no emergency call button to summon help.
Age-Friendly Health Care: Most Medical Facilities Are Poorly Designed for Seniors
As frightening as this sounds, the situation is far from uncommon, Graham suggests. In fact, most health care facilities across America fail to properly accommodate the growing number of senior patients, especially those who are frail or have impaired motor skills. “Most hospitals and clinics have been designed for 40- or 50-year-olds, not 70- or 80-year-olds,” said Dr. Lee Ann Lindquist, Northwestern University chief of geriatrics. “Additional thought has to be given to seniors who have functional disabilities.” In the Kaiser Health News article, Judith Graham lists some specific, practical issues that should be addressed. These are a few of the suggestions that came up repeatedly in her research with geriatric care providers.
- At many clinics and hospitals, “difficulties start in the parking lot,” says Graham. Parking for senior patients may not be close enough to the entrance, and at one busy clinic cited in the article, patients have to cross a busy road that lacks clear signage. So-called disabled parking spaces that offer better accessibility are often in short supply, and many older adults who might need help don’t qualify for a handicapped parking sticker. One idea that some progressive medical facilities are adopting is valet services to meet senior patients at the door, take care of their vehicle, and escort them to the proper office.
- Anyone who has tried to navigate a large hospital knows how easy it is to get lost, especially for older patients. The lack of easy-to-read signs and well-marked corridors “can lead to confusion and unnecessary wandering, accompanied by pain, fatigue and annoyance.” One medical center on Long Island fixed this problem by installing larger signs with bigger type and creating a comprehensive map of the hospital campus to hand to arriving patients. Another hospital installed much larger whiteboards in their patient rooms after discovering that older patients were having trouble reading the names and instructions on the smaller whiteboards.
- It may seem obvious, but older patients using walkers have great difficulty pushing heavy doors open. Automatically-opening doors are a must for any facility catering to seniors. At one clinic cited in the Kaiser article, the front doors open wide automatically but the exit door is manually operated and too heavy, a challenge for those lacking strength and dexterity.
- One geriatric specialist told Kaiser about her “pet peeve”: poorly designed waiting room chairs. Many have seats that are too low, and they also lack arms that a patient can use to push himself or herself up into a standing position. One clinic in Arkansas brought in chairs that are four inches taller than usual and have arms, designed for older patients, and have discovered that these chairs are always occupied while others stand empty. Judith Graham also noted that clinics designed with seniors in mind should offer larger-than-usual exam rooms, so family members can be invited in as needed to share in the conversation between patient and doctor.
Age-Friendly Health Care Starts with Choosing the Right Geriatric Care
Designing medical facilities to better serve seniors is important – but it’s not something over which most of us have much influence. Still, you can make a huge difference for yourself by choosing the right health care provider: a board-certified geriatric physician, better known as a geriatrician. You can always ask your own doctor if he or she has special training in geriatric medicine, but you may have to probe a bit for the answer, and don’t hesitate to ask pointed questions. To find a geriatrician near you, we have two suggestions for you. First, here’s a link to the website of the American Geriatrics Society where you can search for a geriatric specialist in your area. The best option, we suggest, is to call our AgingOptions office and let us refer you to a geriatrician near you. You’ll be glad you did.
If you’re getting serious about retirement planning, you’ll also be very glad you attended one of our AgingOptions LifePlanning Seminars. There you’ll discover a uniquely powerful approach to retirement planning that integrates all the elements of your retirement into one seamless plan: your finances, your housing choices, your legal protection, your health care requirements, and communication with your family. You can explore this breakthrough in retirement planning without cost or obligation. To find out seminar dates, times and locations, and to register online for the seminar of your choice, click on this link to visit our Live Events page, or call our office during the week. Rajiv Nagaich will look forward to meeting you as you explore the power of LifePlanning – your number one tool to ensure a secure and fruitful retirement. Age on!
(originally reported at www.khn.org)