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Characterizing Emergency Department Disposition Conversations for Persons Living With Dementia: Protocol for an
Justine Seidenfeld1,2,3, Matthew Tucker1, Melissa Harris-Gersten1,4
1Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, NC, United States.
JMIR Research Protocols
|December 6, 2024
Summary
This study observed emergency department (ED) disposition conversations for persons with dementia and their care partners. Findings will improve patient-centered care and communication during hospital admission decisions.
Area of Science:
- Gerontology
- Emergency Medicine
- Health Services Research
Background:
- Nearly 40% of individuals with dementia visit the emergency department (ED) annually.
- Hospital disposition decisions (admission vs. discharge) are critical, costly, and complex for dementia patients.
- Current understanding of communication and shared decision-making in ED disposition for dementia patients is limited.
Purpose of the Study:
- To characterize current practices in ED disposition conversations involving persons with dementia and their care partners.
- To gather insights from patient and care partner perspectives on these crucial discussions.
Main Methods:
- An ethnographic design incorporating direct observation of ED encounters.
- Semistructured interviews with patient-care partner dyads to explore decision-making processes.
- Data collection focused on disposition discussions during the ED visit.
Main Results:
- Data collection initiated in October 2023, with 13 dyads recruited and observed as of July 2024.
- Study completion is anticipated by December 2024.
- Preliminary observations are being gathered on real-world disposition conversations.
Conclusions:
- Novel research methods combining observation and interviews offer unique insights into ED disposition for dementia patients.
- Findings are expected to inform the development of more patient-centered interventions.
- Improved understanding can enhance communication and shared decision-making in critical care transitions.
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