MARTIN: The problem for older people is that America's healthcare system was designed for the acute care needs of the young, rather than the often more complex chronic diseases of older adults.
♪ DR. CASSEL: Back in the '70s, there was no specialty of geriatric medicine.
One of the main influences for me was reading Robert Butler's book, "Why Survive?"
It was one of the few places that really pulled together, kind of what I was seeing as a young physician and did it in a very compelling way.
MARTIN: In 1982, Dr. Butler founded the first department of Geriatrics in a U.S. medical school at Mount Sinai in New York City.
DR. CASSEL: Sadly, the field of geriatrics has never really taken off the way Bob Butler envisioned that it would and many of us hoped that it would.
DR. WALTER: There's less than 7,000 geriatricians in the U.S. right now.
I mean, contrast that with over 60,000 pediatricians, you know, it doesn't match up with the whole population aging.
Our health systems have not prepared for an aging population and the issues that come along.
MARTIN: The division of geriatrics at the University of California at San Francisco has developed innovative approaches to address these challenges.
DR. WALTER: We currently do not have enough geriatricians to take care of all the older people in this country, right?
So we absolutely have to train other disciplines and specialties the basic principles of geriatrics.
DR. CASSEL: What's really needed is an interdisciplinary team, we need nursing, we need social work, we need pharmacy, we need occupational and physical therapy.
And together, that can really form a much more effective and cost-effective team.
MARTIN: One of UCSF's innovations is an emergency department that is expressly designed to serve older patients.
DR. WALTER: So in terms of the geriatrics emergency department, we actually call it, our age-friendly emergency department.
And how it works is, well again, it was because people would come in, especially folks who have dementia or have other complex medical illnesses, and they were not getting the care they needed in the emergency department.
DR. DEGESYS: An age-friendly emergency department is a state of mind, not a place.
If you think about coming to an emergency department, nobody likes being there, nobody wants to be there.
It's really somebody's worst day.
You need help getting him on the bed.
And it's even harder for older adults who have impairments with hearing or vision, or they don't have their caregiver with them.
We'll help you, we'll help you.
What makes age-friendly emergency departments different is that they have distinct protocols and policies to care for these vulnerable patients in a completely different way.