Helping older adults return home after a hospital stay

At 80 years old, retired aircraft technician Gregory Gieselman enjoyed an active life gardening, exercising, and spending time with friends and family. During a routine bicycling trip, an unexpected accident sent him to the Trauma Department at Sharp Memorial Hospital, in need of immediate help.

“I was biking across a bridge, took a right turn and collided with someone on an electric scooter,” Gregory says. “I didn’t see it coming.”

An X-ray determined that Gregory had a fractured left clavicle and fractured ribs. He was admitted for further treatment.

Even seemingly minor injuries can have a big impact on a person’s independence. The likelihood of regaining full independence is most at risk in patients age 65 and older. Gregory’s health care team determined he would be a good candidate for Sharp Memorial’s new Geriatric Trauma Program (GTP).

The program is designed for seriously injured patients age 65 years or older — nearly one-third of the 2,900 trauma patients seen at Sharp Memorial each year. As San Diego’s senior population continues to grow, Sharp Memorial recognizes the importance of addressing specific needs for this patient population.

GTP focuses on returning patients to their homes, rather than skilled nursing or rehabilitation facilities. Patients enrolled in the program receive accelerated physical therapy, occupational therapy, speech and cognitive therapy, and respiratory therapy during their stay on the 4 West trauma unit — all in coordination with the patient’s nursing and medical care.

“I appreciated the extra care and attention from the therapists,” Gregory says. “I wanted to get well, so their consistent visits encouraged me to take the program seriously and focus on my health.”

In addition to accelerated therapies, GTP also focuses on sleep strategies to reduce the likelihood of a patient developing delirium.

According to the American Nursing Association, more than 30% of hospitalized patients over the age of 70 experience delirium. The condition is triggered by a sudden and severe change in brain function that causes a person to become confused or disoriented and have difficulties maintaining focus, preventing patients from participating in their recovery.

GTP patients receive at least six hours of uninterrupted sleep and stay in a hospital room facing the sunny side of the hospital.

“Using several innovative methods, we were able to reduce delirium by nearly 100% for the patients in our program,” says Dr. Diane Wintz, medical director of the Trauma Program at Sharp Memorial Hospital.

Since GTP launched in January 2019, there have been no trauma-related readmissions for the 72 patients who have completed the program. Only a few patients left the hospital for a skilled nursing facility, and all transfers were at their own request or the request of a family member.

An avid recreationist, Gregory biked a minimum of 100 miles a week before his accident. He was able to get back to riding six weeks after leaving Sharp Memorial.

“I was extremely pleased with everything during my stay in the hospital,” he says. “I am happy I had the opportunity to participate in the Geriatric Trauma Program because it gave me the chance to get back to doing the things I love.”