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Acute Care for the Elderly Unit (ACE)
Hospitalized
elders often have multiple and complex medical issues,
requiring comprehensive assessment and close attention
by a well coordinated treatment team. Furthermore,
hospitalization for the frail elderly can pose a
significant risk for a decline in general function.
The Acute Care  for the Eldery (ACE)
Unit at Maine Medical Center is specifically
designed to address these needs and to prevent
functional decline in acutely ill, hospitalized,
community dwelling elders and assist them and their
families with the transition back into the community.
This multidisciplinary model of care has been shown
nationally to significantly improve the clinical
outcomes of hospitalized elderly patients, improve their
functional status at discharge and reduce the rates of
transfer to nursing homes. The program's success
lies in its attention to maintaining physical and
psychosocial functioning despite an acute illness and in
its provision of education and support to patients and
their families around medications, geriatric syndromes,
living options and community resources. The philosophy
is further complimented by an environmental design and
that encourages mobility and prevents physical injury.
There is a focus on getting patients out of bed and
moving around as early in the hospital stay as well as attention to delirium prevention.
Patients over the age
of 70 on the ACE Unit at Maine Medical
Center are evaluated for risk factors that can
result in functional decline. These risk factors
include: evidence of geriatric syndromes, such as
hearing or vision impairment; impaired mobility; altered
urinary or bowel elimination; cognitive dysfunction as
evidenced by presence of depression, delirium and/or
dementia; dehydration/malnutrition; impairment of self
care; living alone or with poor social supports;
hospitalization within last 31 days; or evidence of
neglect or abuse. The specifics of the individual cases
are reviewed in a daily interdisciplinary team
meeting. The ACE Unit team at Maine Medical Center includes a
Geriatrician, Advance Practice Geriatric Clinical Nurse
Specialist, Physical or Occupational Therapist,
Dietician, Social Worker, Chaplain representative, Care
Coordinator, Nurse Manager, Nurse Director, Charge
Nurse, Geriatric Psychiatric Nurse Practitioner and a
Pharmacist. This team meets daily to review risk factors
for decline and 
make recommendations to minimize or
modify these factors. The team begins discharge planning
from admission, attempting to identify a reasonable
discharge date and location that takes into
consideration the medical and social considerations of
the individual patient. Individual team members will
meet with patients related to specific issue raised by
the team or expressed by the patient or their
family. In addition, nursing care protocols are
initiated to target risk factors.
Common diagnosis in
patients on the ACE units are likely to be congestive
heart failure, dehydration, mental status change,
gastrointestinal bleeding, pneumonia, stroke, or chronic
obstructive pulmonary disease.
View pictures of
the Acute Care for the Elderly Unit (ACE).
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