A New Paradigm for Elder Care in the ED

New guidelines help address root health problems for geriatric ED visits


To address the possible underlying illnesses and vulnerabilities that lead up to and result from an older person’s ED visit, the American College of Emergency Physicians is launching an accreditation program for emergency rooms to ensure that EDs are senior-friendly and staff are well-equipped to see the fuller pictures of older patients’ health and needs outside the hospital. The accreditation program, which will begin in February 2018, includes guidelines on routine cognitive health screenings, comprehensive medication reviews, and making referrals to community resources like Meals on Wheels.

One goal of the program is to prevent ED visits from becoming a negative “turning point” in older adults’ overall health and independence. In a study published in the Annals of Emergency Medicine, Yale researchers found it’s often not until an older person is admitted to the ED that their existing, underlying health problems come to light. The study compared seniors close in age with similar illnesses and health problems and found that, within six months, a single visit to the ED could make an older person 14% less likely to be able to independently complete tasks of daily living. The study looked only at seniors who weren’t admitted to the hospital after their visit. One possible explanation for this “turning point” is the psychological effect it has: for example, if an older person has to go to the ED for a broken wrist that resulted from a fall, that person might be hesitant to engage in similar activities that might result in another fall.

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