Addressing Psychiatric Problems of Dementiain the Emergency Room

Abstract

Objectives: To review some characteristics of patients with dementia and provide recommendations forcommunicating with them in the emergency room; togive an overview of specific issues regarding the above, their prevalence and consequences, and principles to follow in addressing them in the emergency room.Method: General survey of the literature on this topic.Results: Emergency medicine faces the challenge of providing care to a growing body of patients diagnosed with dementia.Emergency room practitioners have limited geriatric training, and most report being uncomfortable dealing with older adults with cognitive impairment. Aggression, psychosis, resistiveness to care, wandering and neglect/abuse frequently cause these patients to be brought to the emergency room. Capacity to make medical decisions often needs to be quickly determined. A 6-item cognitive screener can be helpful for determining/documenting capacity. Conclusions: With the changing demographics in the healthcare system, implementing a new set of rules and skills geared towards the elderly in the emergency room, especially those with dementia,has become necessary for better care and outcomes.