The Acute Care for the Elderly (ACE) Unit at GBMC is designed to support the medical, functional and social needs of patients over the age of 65 who have an acute condition requiring hospitalization. The ACE Unit features patient-centered treatment in an environment that operates with specialized care guidelines and patient discharge plans, based on the short- and long-term needs of elderly patients. The unit is supported by an interdisciplinary team that includes a geriatrician, specially trained nurses, pharmacist, dietitian and rehabilitation specialists. Patient rooms are equipped with special beds that can be lowered to a level that allows ease of access and decreases the risk of patient falls. Those with medical conditions who are at risk for complications from hospitalization such as delirium, depression, incontinence, falls or those who receive multiple medications are all candidates for admission to the ACE Unit.
Because of the setting and the specially trained interdisciplinary team, a patient can expect:
- A prepared environment: appropriate lighting, soothing colors, de-cluttered areas
- Patient-centered care: individualized patient care based on functional status of each patient
- Appropriate planning for discharge: returning patients to their previous level of function
- Medical Care Review by a geriatrician and the interdisciplinary team
The ACE unit provides an environment in which the care providers are specially trained in the care of the elderly.
The team includes:
- Dr. Aaron Charles, Geriatrician, Medical Director for the ACE Unit
- Linda Henderson, ACE Program Coordinator, coordinates the interdisciplinary team, programmatic development and communication on the unit
- Attending physicians
- Nurses involved in the day-to-day care of elderly patients that receive specific training to address issues the elderly face when hospitalized
- Pharmacists, dieticians, care mangers, rehabilitation specialist, speech and language specialists who are active participants in daily rounds by the interdisciplinary team.
- Nursing support technicians, secretaries, housekeepers and volunteers
To be eligible for admission to the ACE Unit at GBMC, the patient must be at least 65 years old and have an acute condition requiring hospitalization. Patients most at risk for geriatric syndromes such as confusion, dementia, depression, incontinence and falls, or patients who are on multiple medications are all candidates for admission to the ACE unit.
For a direct referral please contact Linda Henderson, at 443-849-3529. A patient who is being admitted to the hospital and meets the ACE admission criteria may also request being placed in the ACE Unit. Ask your physician to request the ACE unit or request ACE if you come into the ED and need hospitalization.
Linda L. Henderson, RN, Program Coordinator ACE Unit
Linda joined the ACE Unit as Manager in December 2006. She has more than 10 years experience in geriatrics in the Baltimore area. Ms. Henderson received her BSN from Johns Hopkins University School of Nursing and has her teaching certificate.
Greater Outcomes is a hospital-wide program designed for geriatric patients to improve function and prevent cognitive/physical decline in the elderly while at GBMC. Volunteers play a very important role in this program by providing sympathetic support, encouragement and companionship to older patients. Some of the activities that the volunteers help with are as follows:
- Making phone calls
- Writing letters
- Playing games
- Having conversations
To improve the health status of the communities and patients we serve, the Community Outreach Program at GBMC is fulfilling its responsibilities and commitment by providing healthcare services to income-restricted residents.
Through the Community Benefits Advisory Committee, GBMC monitors and evaluates its many offerings to ensure members of the community receive health screenings, education and special programs.
Kathy Ruane, CRNP, MPH, is the primary caregiver of the Senior Services Community Outreach Program. Kathy, a nurse practitioner of 32 years visits residents at income-restricted senior independent-living buildings in Towson and treats homeless patients at the Assistance Center for Towson Churches (ACTC). Her duties include monitoring glucose and blood pressure, clarifying and educating people about the medications they take and seeing patients for acute illness if they are unable to visit a doctor. Assisting the aging population to care for themselves is not only Kathy's job; it's her passion. "I can't fix everything that ails someone, but by minimizing the worries and pains, I can help them to live their lives to the fullest," she says.
Palliative Medicine is a sub-specialty of Internal Medicine that focuses on improving the quality of life for those with chronic, debilitating and life-limiting illnesses. Specialized care is provided by a multi-disciplinary team focusing on relieving pain and other physical symptoms and preventing emotional and spiritual suffering.
Palliative Medicine services are available to patients at GBMC as well as affiliated post-acute facilities in the surrounding area.
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Members of the Palliative Medicine team include:
- Dr. Danielle Doberman, a palliative medicine physician, providing expertise in the medications and treatments helpful in reducing pain and other problematic symptoms patients experience as well as helping patients and their families with setting goals for end of life care
- Melissa Wolf, nurse practitioner experienced in symptom management who understands the needs of those with advanced chronic illnesses
- Carla Jackson, a social worker trained to provide emotional support for patients and families
- Chaplaincy services through Spiritual Support Services at GBMC
- The medical personnel providing care for patients at GBMC
Any patient with advanced, debilitating or chronic illness can benefit from this type of service, such as patients with heart disease, dementia, Parkinson's, kidney failure, lung disease or cancer. Palliative Medicine can improve quality of life by focusing on:
- Relieving a patient's pain and other uncomfortable symptoms such as shortness of breath
- Assisting with advance care planning by increasing patients' knowledge of their disease, prognosis and options for treatment
- Supporting family members overwhelmed by navigating the healthcare system
- Counseling patients and family members experiencing emotional and spiritual suffering
Palliative Medicine and Hospice share a common philosophy that focuses on patient and family comfort values. However, Palliative Medicine differs from Hospice in that it is provided at any point in a patient's disease course, from diagnosis onward. It can be combined with curative treatments or be the sole focus of a patient's care.
Patients, family members or any member of the health care team can request a Palliative Medicine consultation. The initial consultation requires a written or verbal order from a physician. The Palliative Medicine Team can be reached by dialing 443-849-6255 or by emailing firstname.lastname@example.org.
The Sub Acute Unit is designed to help patients achieve the highest possible level of independence. Unlike patients in GBMC's ACE unit, patients in the Sub Acute Unit are not hospital patients. Because of this, the Sub Acute Unit is sometimes referred to as transitional care and is licensed as a skilled nursing facility. The patients on this unit have met the acute care criteria for discharge but are still in need of additional assistance and transfer to the Sub Acute Unit to receive rehabilitation to enable them to return to their homes.
Care provided in the Sub Acute Unit includes:
- Intense rehabilitation
- Medical monitoring
- Skilled nursing care
- Careful planning for discharge
A patient's discharge planning begins on admission with a specific set of goals. Often, these are related to rehabilitation. An interdisciplinary team oversees these goals and communicates with the patient and family regarding progress toward them.
The Interdisciplinary Team
Each patient benefits from the team of professionals and their collaborative approach to treatment. The group includes licensed nurses, physical therapists, occupational therapists, speech therapists, clinical dietitians, pharmacists, activity therapists, a social worker and a highly skilled support staff. Management staff includes an administrator, a director of nursing and a Medical Director.
The focus of the Sub Acute Unit is rehabilitation and restorative skilled nursing care. The team cares for patients with diverse diagnoses, including:
- Those who are recovering from joint replacement, fractures or amputations
- Those who have cardiac or respiratory issues
- Those who are rehabilitating from a stroke
- Those who need wound care
- Those with cancer
We evaluate each referral to the Sub Acute Unit using specific criteria. The unit is Medicare-certified and is contracted with a number of private insurance carriers. For information pertaining to coverage, or to make a referral, please call 443-849-2012.
The Sub Acute Unit, located on the fifth floor of the hospital, is designed to help the patient transition back to an independent lifestyle. The setting is warm and homelike, and the staff seeks to make every patient feel comfortable. The unit has its own activities program, and patients are encouraged to participate as a way of furthering recovery and promoting social interaction. Unit amenities include a gracious dining room, an activities space and a large flat screen television. Many patients dress in their own clothing and spend time visiting with friends or family in these common spaces. The unit has its own devoted rehabilitation suite and team of therapists, so patients receive treatment while physically on the unit.