emDocs - October 20, 2015 - Authors: Lo A, Booth K, Hwang U
Edited by: Koyfman A & Bright J.
"Pitfalls
- Look for atypical presentations of common medical conditions
- Avoid admitting to hospital simply because of their age, as unwarranted hospitalization CAN be harmful to the patient’s subsequent function, mobility, and quality of life
- Know your own biases: older adults are a source of stress in EPs; >75% recognize the need to improve quality of care
- 22% of ED admits are potentially avoidable
- 50% of ED admits are for non-clinical reasons
- Address unmet social needs as these are highly responsible for ED returns – ask ED social worker or case manager for help
- Screen for geriatric syndromes to identify older adults at high risk for adverse events
- Delirium (abnormal RASS score) predicts increased mortality at 6 months
- Dementia is unrecognized in the ED up to 70% of the time
- Elder abuse and neglect may have subtle signs/symptoms
- Two mechanical falls in a given year indicates an increased risk of adverse events
- Declines in mobility (e.g. walking speed) is associated with increased hospitalization or mortality
- Potentially Inappropriate Medications (PIMs)"
http://www.emdocs.net/em-approach-to-geriatric-patient-pearls-pitfalls/