In safe hands: Caring for seniors

Dealing with older patients requires a particular skill set and level of understanding.

Although treating a geriatric patient involves the same protocols as treating younger patients, it may take longer to determine the exact cause of their ailment. This is because older adult patients come with their own challenges, which include social, cognitive and physical issues.

Ryan Wills, Training Manager: Emergency Medical Care Mediclinic, says ER24 paramedics might need to “connect many pieces of the puzzle together” when taking a patient history at the scene. “This takes careful consideration and evaluation because the cause of an elderly person’s condition might not be as obvious as other patient groups,” he says. “If a young person collapses, the reasons are generally clear. With older patients, there are more aspects we need to consider.”

Wills explains that geriatric patients are at increased risk of certain age-related conditions – and ER24 staff are trained to be mindful of this fact. “These conditions include cardiac-related issues such as heart attacks and respiratory conditions such as emphysema – a lung condition that causes shortness of breath, and chronic bronchitis,” he says. “Older patients are also more prone to falls, have a higher risk of developing cancer and are also more likely to develop dementia or Alzheimer’s. If they aren’t successfully managing a chronic condition, such as diabetes, they might also present with dehydration or electrolyte disturbances.”

When dealing with elderly patients, ER24 paramedics are trained to:

Communicate
Instead of directing all questions to the relative, friend or neighbour who might be on the scene, they talk directly to the patient if possible. Due to body changes associated with ageing, communicating with the elderly may be difficult and occasionally frustrating. The patient should be using their glasses, hearing aids or false teeth to make communication easier.

Be gentle

Geriatric patients usually have thin, fragile skin. To avoid unnecessary bruising or tearing, paramedics are extra careful when examining the patient or removing bandages. “We do handle older patients more carefully and are aware of how we position them on a stretcher if they’re being transferred to hospital, particularly over a long distance. Older people are more prone to pressure injuries (bedsores or wounds) and can develop complications from pressure-related injuries. If these don’t heal quickly, they can become septic and lead to further problems.”

Check the medication

Many elderly people may experience complications if they forget to take chronic medication – or take too much of it by mistake. An ER24 paramedic will try to establish the patient’s medication regime, to ensure there is no possibility of a negative reaction to medication administered on the scene.

Senior-related calls are not always medical emergencies. “Sometimes family members get frustrated with an elderly relative who has developed senility or unusual habits,” Ryan says. “We often have to act as mediators between the family and the older person, explaining that if there is no physical reason for them to be admitted to hospital, the hospital will simply send them home. In these situations, we try to involve a social worker or counsellor, who may be able to assist more appropriately.”

No matter the circumstances, the ER24 paramedics are trained to deal with elderly patients with reassurance and patience. “It’s challenging getting older, and many geriatrics are anxious, fearful and mistrusting of strangers,” Wills explains. “They may also be experiencing depression and loneliness, and our first responders need to be mindful of that. We encourage them to approach the elderly patient in an understanding, caring and non-threatening way.

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