Dr. Zia Agha

Master Plan for Aging

An older man and his overwhelmed caregiver daughter told the emergency room nurse that he was dizzy and at risk of falling. A typical hospital might order a battery of tests and keep him overnight while doctors tried to figure out the cause of his vertigo.

But this wasn’t a typical ER, and this wasn’t a normal ER nurse. This patient visited the Gary and Mary West Senior Emergency Care Unit at the University of California at San Diego, a flagship for accredited geriatric care. Jennifer Clay, who is trained in geriatrics, was the nurse who worked with the older man and his daughter to look at all the sensory components of what might put him at risk for falls, from recognizing he was hard of hearing and did not have an assistive device at home to reviewing medication that might contribute to dizziness. Jennifer’s sharp eye helped the man be quickly and safely discharged home, armed with resources, support, and a plan of care tailored to his specific needs.

Older adults are seeing the benefits of specialized care in accredited geriatric emergency departments (EDs), including fewer nights away from home and fewer associated costs.

"It’s not rocket science. Patients do much better recuperating at home," Dr. Zia Agha, chief medical officer at West Health, says.

The success of geriatric emergency departments is helping them spread. In 2018, only a handful of hospitals in the United States had geriatric EDs; six years later, more than 450 do. That includes 83 in California, where 41% of older adults now can get specialized care — the highest rate in the nation.

Such rapid growth to benefit older Californians, Dr. Agha says, is truly "extraordinary."

Geriatric EDs reflect how aging services — evolving for 50 years in California — have changed to serve a growing and changing population.

Go Back