Paramedics have been an integral part of the healthcare landscape since the 1970s, when emergency medical services (EMS) were first widely implemented. Today, these highly trained professionals respond in situations commonly affecting older adults.
Writing on history can be instructive—the facts, the context in which they’re found and the words used to describe events. In 1890, Burdett described The Home for The Aged and Infirm Hebrews (of New York City, now The New Jewish Home) as follows:
In the early 20th century, the architect Louis Sullivan designed very tall buildings to meet the needs of a newly urban population. These structures illustrated his assertion that “form follows function.” The new forms needed a new name, and “skyscrapers” fit perfectly.
I walked up to a patient in the Emergency Department, a woman in her 90s who had fallen. She had a decent-size laceration on her forehead and was quite upset. Unable to tell me what had happened, or how she fell, I had to rely on the EMS history. Luckily, the EMTs were still there and could tell me that she had a history of dementia, had fallen at home (where she lived alone) and had been unable to get up for a couple of hours. A neighbor walking by had heard her cries and called 911.
In recent years, improving health outcomes and reducing healthcare expenditures for Medicare and Medicaid beneficiaries has become increasingly imperative. Several initiatives in the Affordable Care Act (ACA) provide incentives to hospitals and medical providers to achieve the triple aim of improving the patient care experience, improving population health, and reducing the per capita cost of healthcare.