Hospitals and rest homes need to do a better job coordinating their efforts to help seniors, according to an elder care employee.

Geriatric aid Derrick Crofton currently works at Sandys Rest Home and has worked with the elderly for more than 15 years.

Mr. Crofton told The Royal Gazette that hospital staff and geriatric aids needed to work together caring for the elderly -- especially in emergency situations.

"Whenever the GAs call the hospital, we have a problem and have to go the whole nine yards to get the ambulance to come and pick up elderly patients,'' he said.

"We're the hands-on people -- we know everything about the resident because we're trained to observe and report.

"But we seem to be in total conflict with the people above us, i.e. the nurses.

"Many of the smaller nursing homes are not equipped to deal with emergency situations.

"But once a patient becomes incapacitated -- as a result of stroke or other problems -- we can no longer adequately care for them.

"And trying to get them transferred out of the rest home under those circumstances is very, very difficult.

"They think we're trying to get rid of them -- into the hospital, out of the rest home.'' "But we really need someone to be a champion for the elderly at the hospital,'' he said.

Mr. Crofton said he believed the hospital staff often felt the rest homes were "crying wolf'' over elderly patients who exhibited medical symptoms that may or may not be serious.

He stated: "I understand the hospital's point of view and their frustration -- it's not unusual for the elderly to have elevated vital signs.

"A patient's vital signs could be haywire and then stabilise on the way to the hospital -- but as a GA, I can't assume anything.

"There was one instance where we called the hospital about someone who was having a problem. The hospital sent him back, and he ended up having to undergo emergency surgery that same day.

"But the question becomes, how do we go about coordinating efforts between the rest homes and the hospital? "These people have worked hard and made Bermuda what it is today. The least we could do is make them comfortable in their last days.'' Chief Medical Officer John Cann agreed there were a number of areas in elder care that should be improved.

He mentioned that there were regular meetings among rest home matrons and stated: "The lines of communication are there, but the real question is, why aren't people using them?'' When asked if it was difficult transferring the elderly from rest homes to the hospital, Dr. Cann said: "Yes, that sometimes can be a problem that we are currently working to improve...there are a number of things currently in the pipelines.'' He said consultants to the Health Ministry recently met to develop a set of core home care standards, including a self-accreditation system for rest homes.

And Dr. Cann said that a new generic manual for rest homes laying out guidelines for job descriptions and procedures was effectively completed and currently in the editing process.

"We are exploring options such as establishing a crisis team to deal with rest home patients when they may need more intensive care for, say, a 24-hour period,'' said Dr. Cann.

"We also have to move people who don't need to be in a rest home back into the community to free up beds, and we need more community support systems to do this,'' he said.

Hospital spokesperson Kendaree Burgess-Fairn said: "There aren't any standards in place for communication between the rest homes and the hospitals, since each of the rest homes operates differently.

"But if there is an emergency case, we respond as we would for any other emergency...it's only the transport calls that may be delayed.

"And there is a fairly standardised procedure for transferring patients from the rest home to the extended care unit at the hospital,'' she added.

Health and Social Services Minister Wayne Furbert did not return phone calls yesterday.