Have you ever been to an emergency medicine center (EMC)? The answer for many of us is yes. We may have been there when we became ill after our doctor's office closed, when we broke a bone, were in a car accident or had a heart attack.
Most of us assume that when we need such care it will be available. Aren't emergency services a public obligation?It seems, however, that the public is not paying enough attention to the emergency-care system nationally, and serious cracks are now evident. Recent articles in the New York Times have spotlighted efforts to unclog crowded EMCs. And reports in the Wall Street Journal have examined hospital "dumping" practices: Each year, 250,000 emergency patients are transferred to other hospitals for economic, not medical, reasons.
The Los Angeles Times chronicled a series of permanent and temporary shutdowns of county EMCs in that area. This sent paramedic units scurrying from one hospital to another. The cause is the inability of hospitals to absorb the costs of treating indigent patients.
The strains on emergency-care facilities may jeopardize the health of anyone in need of urgent attention. The elderly should be of special concern. Older people represent a greater percentage of the population than at any time in history, and EMCs are treating more older adults. They are at risk because they often have multiple illnesses that complicate treatment.
Moreover, older patients do not always seek care even when they have major symptoms. This delay may lead to late diagnosis and poor outcomes, according to Dr. Richard Besdine of the University of Connecticut.
The system has not made the necessary adjustments for the growth in the elderly population. Most EMC nurses, physicians and trauma technicians have little training in geriatrics. A survey of three paramedic-training centers in Los Angeles found that only one school offered any geriatric classes - a one-hour lecture.
While a myriad of issues face emergency medical care, one that must not be neglected is how to better care for the elderly who use the EMC system - Elyse Salend
QUESTION: My wife and I retired and moved to an adults-only condominium in Florida in 1980. We have nothing against children, but prefer to live with adults who have similar interests. A rumor is sweeping our complex that a new law willallow families with young children to live here. Can you tell us about it?
ANSWER: In mid-March, legislation went into effect that may have an impact on communities such as yours. The new law, an amendment to the federal Fair Housing Act, seeks to prevent most communities from banning children. The law applies to rental units and condominiums, and is sure to raise legal challenges across the country.
According to the new law, children can be barred from a development under two provisions: if all the residents are 62 years of age or older, or if at least 80 percent of the units are occupied by one person 55 years or older and the property has special facilities for older people.
There is sure to be an increase in lawsuits over the legislation. Your homeowners' association should explore the new law with a lawyer.
Send questions about growing older to On Aging, P.O. Box 84256, Los Angeles, Calif. 90073. Questions of general interest will be answered in the column; individual answers cannot be provided.