Subscriber OnlyHealth

One small change: A geriatrician on how to make Ireland’s health system better

Prof Rose Anne Kenny wants ‘a dedicated space in emergency departments for older people’

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear from doctors, nurses, paramedics, medical secretaries, hospital porters, canteen staff and others about one change they would like to see in our health system.

It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone.

If you are interested in sharing your idea, you can email (put "One Small Change" in the subject line), or fill in the online box below. Thank you.

Prof Rose Anne Kenny

(Geriatrician and director of the Mercer’s Institute of Successful Ageing at St James Hospital Dublin)


“I would like to see a dedicated space and system in emergency departments for older people. Emergency departments are busy places with staff under a lot of pressure and dealing with many different demands. Older patients attend emergency departments more often than other age groups. They often have multiple chronic conditions and have more physical and social challenges.

“Some older patients have intimidating or frightening experiences in the emergency department where they may not be able to clearly hear or understand questions and communications. Some may be confused as a result of their illness whereas others suffer from chronic cognitive issues such as dementia.

“A dedicated space within an otherwise busy department where appropriately trained staff could dedicate more time to interact with older patients and in a paced manner would ensure better short- and long-term health outcomes.

“In 2018, the American College of Emergency Physicians launched a new initiative to accredit emergency departments for specialist geriatric emergency department status. This accreditation – which over 50 hospitals in the US now has – greatly enhances emergency care for older patients by ensuring the necessary expertise, equipment and personnel to provide optimal care.

"By 2030, one in five adults in Ireland will be over 65. The demand for geriatric care will grow rapidly because of this. Having dedicated areas within emergency departments in Ireland would help hospitals prepare to meet the care needs of our rapidly expanding ageing population and provide a better service for all."