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Nurses carry “pocket talkers,” small amplifiers that hook to headphones so they don’t have to yell if a patient’s hard of hearing.

Mattresses are thicker, and patients who don’t need to lay flat can opt for cushy reclining chairs instead; Moccia says people feel better when they can stay upright. Nonskid floors guard against falls. Forms are printed in larger type, to help patients read their care instructions when it’s time to go home. Pharmacists automatically check if patients’ routine medications could cause dangerous interactions. A geriatric social worker is on hand to arrange for Meals on Wheels or other resources.

“In the senior unit, they’re just a lot more gentle,” says Betty Barry, 87, of White Lake, Mich., who recently went to another of Trinity’s senior ERs while suffering debilitating hip pain.

But Moccia says the real change comes because nurses and doctors undergo training to dig deeper into patients’ lives. While they’re awaiting test results or treatments, every senior gets checked for signs of depression, dementia or delirium.

An example: A diabetic was treated for low blood sugar in a regular ER. A few weeks later she was back, but the newly opened senior ER uncovered that dementia was making her mess up her insulin dose, repeatedly triggering the problem, says Dr. Bill Thomas, a geriatrician at the University of Maryland Baltimore County who is advising Trinity Health Novi’s senior ER program.

It doesn’t take opening a separate ER to improve older patients’ care, says New Jersey’s Rosenberg, who calls better overall geriatric awareness and training the real key. Still, he says his center saw a 15 percent rise in patients last year.

“Those hospitals that have the money and space and the luxury to do something like that are going to get a definite advantage down the road,” predicts John at the American College of Emergency Physicians, who says his own Boston hospital didn’t have the money to try it.