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Press Release
Elderly Benefit Physically, Mentally from VA Evaluation and Management Methods
Release Wednesday March 20, 5 pm EST
Researchers from the Department of Veterans Affairs (VA) have determined that significant quality-of-life benefits for the frail and elderly may result from patient care in geriatric evaluation and management units (GEMU) and clinics (GEMC). The GEM-team method uses a multi-disciplined group of medical professionals to care for patients' many physical and emotional needs. Findings show significant reductions in physical ailments and better mental health for GEM patients -- all accomplished with no increased cost.
The findings, published in the March 21 issue of The New England Journal of Medicine, are the result of a VA Cooperative Studies effort involving 1,388 frail, elderly patients from 11 VA medical centers. Some patients received GEM care while a control group received traditional care. According to lead author Harvey Cohen, M.D., patients lived just as long under GEM care as they might under traditional care, but their quality of life was enhanced by improved physical and mental health.
GEMU deals exclusively with inpatient care, whereas GEMC provides treatment on an outpatient basis. Both have been found to offer unique healthcare benefits. Dr. Cohen attributes this success, in part, to GEM's awareness and attentiveness to both the physical and emotional needs of the patient.
"Both GEM programs take a multi-faceted team approach to inpatient and outpatient services for elderly patients, including treatment, rehabilitation, health promotion and social service interventions," said Dr. Cohen.
GEMU inpatient care appears to most significantly benefit patients' physical health. GEM teams were able to closely monitor, treat and prevent physical ailments more effectively than might be possible in a traditional environment.
"Older, frail patients run a significant risk of losing their physical vitality any time they come into a hospital," said Dr. Cohen. "Quality of life improvements for these patients are a very important thing - for some patients, quality of life issues are vastly more important than length of life issues. These findings represent some meaningful benefit in that regard."
The improved mental health of GEMC outpatients may be linked to better recognition of depressive states. A GEM team operates on a foundation of conspicuous availability for patient support and an acute awareness of mental health needs.
"A team's awareness of an outpatient's mental and emotional needs, and their attentiveness to those needs can make all the difference in providing effective diagnosis and treatment," said Dr. Cohen.
The first VA GEM was opened in June 1976 at the VA Medical Center in Little Rock. Previously published findings showed that many new major psychiatric conditions were discovered in these GEM patients transferred from acute and medical and surgical wards.
In light of the current study's encouraging findings, VA researchers plan to continue studying methods of inpatient and outpatient geriatric evaluation and management. Continued research will help the VA develop the best possible care for elderly and sometimes frail patients.
This research was funded by the VA Cooperative Studies Program. Co-authoring the findings, with Dr. Cohen were John R. Feussner, MD., Morris Weinberger, Ph.D., Molly Carnes, MD., Ronald C. Hamdy, MD., Frank Hsieh, Ph.D., Ciaran Phibbs, Ph.D., Philip Lavori, Ph.D.
Research is an intrinsic part of the VA mission that benefits veterans and non-veterans.
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