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SUNY Downstate Health Sciences University

Department of Emergency Medicine

Geriatric Emergency Medicine

Increased life expectancy has resulted in an ever growing number of elderly patients. This "Graying of America" has resulted in many more acutelly ill geriatric patient presenting to the Emergency Department and utilizing more emergency resources. Their physiologic response to illness, injury and treament is different. They often present with more complex poblems, more illnesses, more atypical presentations that are more likely to be misdiagnosed, and they are more prone to have adverse drug reactions. The elderly usually do not tolerate acute illness well and often rapidly decompensate. Studies have shown that there is insufficient teaching, training and emphasis on the acute care of geriatric patients.

In response to the need for better emergency care for the elderly and for more training in this area for Emergency Medicine Residents, the Department of Emergency Medicine at SUNY Downstate / Kings County Hospital Center has created a Sub-Division of Geriatric Emergency Medicine (GEM). Dr. Joel Gernsheimer, who is Board Certified in Geriatrics in addition to Emergency Medicine, will direct this new sub-division. He will be assisted in this mission to improve the quality of emergency care provided for our elderly patents and the training in this area given to our residents by Dr. Stephan Rinnert, Dr. Bonny Baron, Dr. Jessica Stetz, and Dr. Bonny Arquilla.

The mission, goals and objectives of the Sub-Division of Geriatric Emergency Medicine are to:

  1. Provide optimal medical care for the elderly, including social support, in our Emergency Department
  2. Establish guidelines for the emergency care of geriatric patients.
  3. Develop quality care indicators and monitor the care given to our elderly patients.
  4. Address the special needs of the geriatric trauma patient, including elder abuse
  5. Coordinate the care of geriatric patients treated in the ED with the family, nursing, primary care physicians and other health providers, and social workers.
  6. Address Pre-Hospital Care and Disaster Management as it pertains to the geriatric population.
  7. Educate Emergency Medicine Residents and Faculty, residents and faculty from other specialties, medical students and other health care providers in the areas of Geriatric Emergency Medicine and Palliative Care.
  8. Address legal, ethical and end of life issues pertaining to the care of the elderly.
  9. Conduct Geriatric Emergency Medicine Research.
  10. Obtain research and service grants.
  11. Partner with outside institutions, such as nursing homes, and agencies in order to improve the overall care given to the elderly population, including developing better support and systems and social structures. This would not only encompass the acute cafre but also health care maintenance and injury preventiion for this vulnerable population.
  12. To explore the possibility of establishing a Geriatric Emergency Medicine Fellowship at our institution.