Moving towards the Age-friendly hospital. A paradigm shift for the hospital-based care of the elderly.

Abstract

Care of the older adult in the acute care hospital is becoming more challenging. Patients 65-years and older account for 35% of hospital discharges and 45% of hospital days. Up to one-third of the hospitalized frail elderly loses independent functioning in one or more activities of daily living as a result of the ‘hostile environment’ that is present in the acute hospitals. A critical deficit of health care workers with expertise and experience in the care of the elderly also jeopardizes successful care delivery in the acute hospital setting.

We propose a paradigm shift in the culture and practice of event-driven acute hospital-based care of the elderly which we call the Age-Friendly Hospital concept. Guiding principles include: a favorable physical environment; zero tolerance for ageism throughout the organization; an integrated process to develop comprehensive services using the geriatric approach; assistance with appropriateness decision-making and fostering links between the hospital and the community.

Summary The Age-Friendly Hospital concept we propose may lead the way to enable hospitals in the fast-moving health care system to deliver high quality care without jeopardizing risk-benefit, function, and quality of life balances for the frail elderly.