How to create your own Geri Suits for your Geriatric Emergency Department
What is a Geri Suit?
Aging simulation suits (or “Geri Suits”) enable users to personally experience a variety of age-related physical and sensory challenges. The experience can help people to develop a unique sensitivity and understanding towards older adults. The suits are particularly useful for health care providers caring for older adults to use to better understand their patients and the challenges they may be facing, in order to provide more informed care.
Physical and sensory challenges that the suits can stimulate include:
- Visual impairment
- Hearing impairment
- Decreased mobility
- Stooped posture
- Loss of sensation in hands
- Joint stiffness
- Loss of strength
- Decreased sense of balance
Why create your own Geri Suits?
Commercial aging simulation suits can cost thousands of dollars per suit. Homemade suits can be put together for just a couple of hundred dollars. Making the suits yourself could save your institution money, while still allowing staff and learners to still partake in experiential learning. You can also get creative in terms of what the suits include – what are the aging-related challenges you want to simulate? How might you be able to simulate them at a low-cost, or even better, with already existing equipment and supplies?
How did University Health Network develop our own Geri Suits?
At University Health Network (UHN) in Toronto, Ontario, we developed our own Geri Suits, inspired by using commercial suits as part of the geriatric curriculum for residents developed by Dr. Alice Gray and the work of Dr. Brittany Ellis at the University of Saskatchewan. This work was part of UHN’s Geriatric Emergency Department Initiative (GEDI), a new initiative made possible by donors and aimed at improving care, experiences and outcomes for older adults visiting UHN’s Emergency Departments (EDs).
Process:
- Made a list of what kind of aging-related impairments we wanted the suit to simulate.
- Brainstormed low-cost items that could simulate those impairments.
- Sourced the items and put the Geri Suits together.
- Created a Geri Suit inventory and guide for educators and staff.
- Tested the Geri Suits with staff and identified areas for improvement.
- Implemented improvements and will continue to test and improve on an ongoing basis.
The suits we created cost just $264 CAD each, or $205 USD.
What do the UHN Geri Suits include?
click on the items listed below for a link to purchase
| Item | Single Use? | Quantity per Suit | Cost per Suit ($CAD) | Purpose |
| Ankle and wrist weights | 4 | 51.68 | To simulate muscle atrophy and increased fatigue with everyday exercises | |
| Cane
|
1 | 15.99 | Intentionally wrong height to simulate poorly fitted mobility device | |
| Duffle bag
|
1 | 29.99 | To hold Geri Suit items | |
| Ear plugs (pack of 120)
|
x | 2 | 21.99 (only one pack needed for multiple suits) | To simulate hearing loss |
| Elbow braces
|
2 | 48.18 | To simulate limited mobility / arthritis | |
| Knee braces
|
2 | 91.18 | To simulate limited mobility / arthritis | |
| Noise-cancelling headphones
|
1 | 19.99 | To simulate hearing loss | |
| Soft c-collar
|
1 | 26.25 | To limit neck mobility | |
| Medication bottle / blister pack filled with candy
|
1 | 0.00 (obtained from pharmacy) | To use for medication exercise | |
| Overalls
|
1 | 36.94 | To simulate stooped posture | |
| Plastic glasses
|
1 | 1.25 | Dark and sanded / covered with Vaseline to simulate vision loss | |
| Posture braces
|
1 | 11.99 | Worn backwards to simulate stooped posture | |
| Slippers
|
1 | 2.68 | To simulate neuropathy and/or instability | |
| Thin gloves
|
4 | 2.98 | To reduce tactile response / sensory neuropathy | |
| TOTAL | 264.08 |
What do the UHN Geri Suits look like?
How has UHN used the Geri Suits?
To educate our Geriatric ED staff
We use the Geri Suits to provide simulation education to groups of ED staff and learners. Staff and learners complete various exercises while wearing the suits in order to better understand the experiences of older patients in the ED and some of the challenges unique to this population. When groups experience the Geri Suits together, conversations are enriched as they are able to share their experiences as they complete various exercises. This group dynamic leads to deeper discussion and better understanding of the impact of the Geri suits. This experience leads to deep discussion and understanding of how staff and learners can improve their management and care of older persons in the ED.
Exercises:
- Opening medication bottles and taking correct medication out
- Ambulating and attempting to fill a urine cup (filled from a basin of water)
- Filling out an intake form
- Completing a Mini–Mental State Examination (MMSE)
- Completing a Timed Up and Go test
To improve physical environments and services for older adults
We used the Geri Suits in situ to test the design, accessibility, and patient flow of UHN’s newly
constructed Rapid Assessment Centre (RAC). Staff donned the suits and navigated the space as patients.
Throughout the exercise, they identified aspects of the space that could be potentially challenging for
older patients and we were able to mitigate these hazards before the space opened to the public.
Areas for improvement identified:
- Need for specialized geriatric equipment in certain areas.
- Potential tripping hazards.
- Ramp steepness as a potential hazard.
- Corners may be difficult to navigate with a mobility device.
- Wayfinding may be challenging for someone with stiff neck, visual impairment, or cognitive impairment.
- Low chairs make getting up from sitting difficult.
- Ambient noise in certain areas challenging for patients with hearing impairment.
Consider doing a stand alone geriatric simulation session, or incorporating it into any simulation
education your ED already has. You can use these suits to adapt scenarios you already have, especially if
they are communication focused, or build on your own cases around common ED presentations like
minor trauma.
“Wearing the Geri Suit was very eye opening for me to experience first hand the physical and sensory changes that may impact older patients – specifically decreased mobility and ROM, hearing/vision impairments, joint stiffness – and the challenges our older patients may experience when accessing care in the ED as a result of these changes. These are challenges I may not have initially considered/identified if I had navigated the space without the Geri Suit, such as difficulty getting up from a waiting room chair or walking down a ramp with a gait aid, and being unable to see wayfinding signs. The simulation not only allowed us to identify opportunities to improve safety & accessibility but increased my own understanding/appreciation for the needs of older adults and the importance of considering the unique challenges this population may face with the use of the Geri Suit to ultimately improve the care we provide.”
– Kristen Cunningham, Advanced Practice Nurse Educator, University Health Network
Contributors:
Alexandra Piatkowski, Dr. Alice Gray, Dr. Thom Ringer, Dr. Tahara Bhate, Dr. Alia Dharamsi, Sarah
McDermid Flabbi, Laura Pozzobon, Kristen Cunningham, University Health Network, Toronto, Ontario.