“The overall treatment goal is to get the patient back to their original functional level, or at least as well as possible,” says Dr. Landefeld. “When you look at things through that lens, the goal becomes less focused on finding the best antibiotic or anti-thrombolytic, and more on the broader picture of getting the person home.”
Hospitalists and geriatricians should join forces, he adds. At the University of California, San Francisco, they worked together to create the Acute Care for Elders (ACE) units, wards designed for patients who are at least 75. Importantly, nurses play a prominent role in addressing these patient challenges because they are often familiar with the problems these patients have performing simple tasks, such as walking and eating.
UCSF also has established post-discharge clinics—another joint hospitalist-geriatrician venture—where elderly patients can be followed after they leave the hospital. And geriatricians can help hospitalists ensure there are programs in place to let patients make the transition from hospital to home or assisted living as smoothly as possible. TH