Emergency Department presentation of frail older people and interventions for management: Geriatric Emergency Department Intervention

Alison Craswell,Andrea Taylor,Marianne Wallis,Elizabeth Marsden

doi:10.1186/s40886-016-0049-y

Alison Craswell, Andrea Taylor + Show 2 more

Open Access

https://doi.org/10.1186/s40886-016-0049-y

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Abstract

As population’s age and people live longer, the burden on acute health care services associated with the frail aged increases. Recognising the needs of this cohort as well as designing and evaluating interventions to manage their care in the emergency department has been reported in the literature. Transition to new models of care in emergency departments (ED) focused on improving the care of older people can also assist in reducing length of stay in the ED, reducing complications associated with ED presentation and prevent inappropriate hospitalisation. The Geriatric Emergency Department Intervention (GEDI) aims to build on the successful components of other models of care for older people in acute healthcare settings to improve safety and best meet the needs of both older people and health service providers.

Highlights

In the developed world, the proportion of the populations of people aged 65 years and over are increasing at a disproportionate rate, compared to other age groups, resulting in an increased burden on health systems as a consequence of the chronic disease and frailty experienced by this cohort [1]
Some examples of these interventions are: improving care in residential aged care facilities (RACF) via change in staffing models most often to include a Nurse Practitioner [11], interventions in Emergency departments (ED) for presentation of older people, and outreach models from health services to the community most often provided by nurses, hospital in the home (HITH) and hospital in the nursing home (HINH)
There is some evidence that outreach interventions such as HiTH and Hospital in the Nursing Home (HINH) as exemplars for supported early discharge result in decreased admission rates from RACFs to EDs and reduced length of stay if admitted [13, 20, 21]

Summary

Introduction

The proportion of the populations of people aged 65 years and over are increasing at a disproportionate rate, compared to other age groups, resulting in an increased burden on health systems as a consequence of the chronic disease and frailty experienced by this cohort [1]. Some examples of these interventions are: improving care in RACFs via change in staffing models most often to include a Nurse Practitioner [11], interventions in EDs for presentation of older people, and outreach models from health services to the community most often provided by nurses, hospital in the home (HITH) and hospital in the nursing home (HINH).

Results

Conclusion