Functional assessment of older adults in an emergency department

The fast paced nature of emergency medicine often precludes assessment of patient functioning which may have significant consequences for geriatric patients including falls, functional decline and/or hospital re-admission. A rehabilitation consultation service to a hospital emergency department was implemented based on recommendations in the literature that functional assessments and a multidisciplinary approach be used with older adults. A systematic method of targeting and assessing elderly at-risk patients included a safety checklist and a comprehensive functional assessment tool. An observational study of 80 patients receiving functional assessments from rehabilitation professionals is described. Patients with high levels of disability or who lived alone prior to the emergency visit were more likely to be admitted to hospital. This study supports using multidisciplinary efforts and comprehensive functional assessments in emergency departments to guide decision-making about discharge outcome and planning for the health care needs of elderly patients.