Gerontological Nursing and comprehensive geriatric assessment in the emergency department

The Geriatric Emergency Management (GEM) Nurse Program provides specialized geriatric emergency management services to frail seniors in the hospital Emergency Department (ED). GEM programs are located at various hospital Emergency Department locations across the Central East LHIN and are led by a GEM nurse. GEM nurses provide targeted comprehensive geriatric assessments (CGA) and interventions to at-risk seniors, in order to connect them with services to better meet their health needs. There are currently nine GEM nurses working at nine hospital locations within the Central East LHIN, including:

  • Peterborough Regional Health Centre, Peterborough
  • Ross Memorial Hospital, Lindsay
  • Northumberland Hills Hospital, Cobourg
  • Lakeridge Health:
    • Ajax-Pickering Campus, Ajax
    • Bowmanville Campus
    • Oshawa Campus
  • Scarborough Health Network:
    • Birchmount Campus, Scarborough
    • Centenary Campus, Toronto
    • General Campus, Scarborough

Program Goal

The goal of the GEM program is to deliver targeted, emergency geriatric assessment to frail seniors in the Emergency Department, and to help seniors’ access appropriate services and/or resources that will enhance functional status, independence and quality of life. Further, GEM nurses strive to build geriatric and senior-friendly programming within the hospital Emergency Department through collaboration, knowledge transfer, and education opportunities with other staff across the rest of the hospital in many different fields and departments as needed. Additionally, GEM nurses are positioned to have strong networks and affiliations in the community to further support seniors after they leave the hospital to return home.

Meeting the Need

Frail older adults represent as many as 30% of the patients seen in hospital Emergency Departments, more than any other age group. Illness complexity, hospital admission rates, lengths of stay and risk of functional decline are also highest for seniors. Emergency department visits are often life changing events for seniors, threatening their loss of independence, health and well-being. By providing specialized frailty friendly services in emergency departments, individual decline and loss of independence can often be prevented or postponed.