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Comprehensive geriatric assessment in the emergency department
Graham Ellis1, Trudi Marshall2, Claire Ritchie2
1Medicine for the Elderly, Monklands Hospital, Airdrie, Scotland, UK.
Clinical Interventions in Aging
|December 5, 2014
Summary
Older adults, especially those with frailty, increasingly use emergency departments (EDs), facing longer waits and poorer outcomes. Specialized geriatric care models in the ED show promise for improving outcomes and reducing hospital admissions.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Public Health
Background:
- Global demographics show a rising number of older adults presenting to emergency departments (EDs).
- Older patients often have complex needs, including multiple comorbidities and frailty, leading to increased resource utilization and poorer health outcomes.
- Current ED care models may not adequately address the unique challenges and needs of older adults, particularly those with frailty.
Purpose of the Study:
- To highlight the increasing burden of older adults, especially those with frailty, in emergency departments.
- To discuss the complexities and challenges in assessing and managing frail older adults in the ED.
- To explore the potential of evolving care models, such as comprehensive geriatric assessment, within the ED setting.
Main Methods:
- Review of current literature on geriatric care in emergency settings.
- Analysis of demographic trends and their impact on ED services.
- Examination of specialized care models, including multidisciplinary teams and comprehensive geriatric assessment.
- Identification of key challenges like delirium, functional decline, and carer strain.
Main Results:
- Older adults, particularly those with frailty, experience longer waits, higher admission rates, and worse outcomes in EDs.
- Frail older adults may present atypically, necessitating multidimensional and multidisciplinary assessment.
- Comprehensive geriatric assessment models delivered by specialist teams in the ED are demonstrating improved patient outcomes.
- These interventions can lead to reduced hospital admissions, mortality, and dependence.
Conclusions:
- Adapting geriatric medicine principles for the urgent-care environment is crucial for managing the growing population of older adults in EDs.
- Multidimensional assessment and multidisciplinary care, exemplified by comprehensive geriatric assessment, are effective in improving outcomes for frail older patients.
- Implementing specialized ED care models can mitigate negative outcomes and enhance patient satisfaction for older adults.
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