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6 thoughts on “Building a Better Emergency Department for Older People

  1. How exciting to hear that there are changes beginning to be made.  Bravo!  Now to get hospitals to recognize the need for training their line staff in dementia care too!  That would be a huge quality of life improvement for all concerned.  Thanks for passing on this information Nora.  

  2. Hi Nora,

    Great article! Completely agree! I think overall the medical system needs to be more supportive of older adults. As a renal social worker in an outpatient dialysis clinic, I have older adult patients who come to me after going into the ED and then the ICU with news that they need to start dialysis (and were not followed by a nephrologist pre-ESRD). From my experience, these older adults are ill informed about the demands of dialysis (shame on the MD’s) and/or are not completely competent when they start (which is a process to figure out who is the HCP and contact the MD etc to figure out what to do). Upon the first day of outpatient dialysis, I have had a few older adult patients say something along the line of “i only need this tx for today”, when in reality it is for the rest of their life and I break the bad news. I really think its a shame that I have patients starting dialysis well into their 80s who are extremely frail (and their families and MD’s pushing them to start and stay on). I had an older adult patient who was medically extremely frail, started one dialysis tx with us, and then went back into the ED, was admitted into the ICU, and then passed away (she really should have been on hospice OR stayed in the hospital as an acute dialysis patient, as she was extremely frail to even start outpt dialysis…). I wonder with a ED focused on older adults how that may impact my older adult patients on dialysis?

  3. A wonderful hope building article. Would that more EDs would follow their lead. It is an interesting and important subject to keep tabs on. Monitoring changes might act as a spur to others to follow suit.

  4. Thank you Claire, Marianne and Felicia for your comments. It is wonderful to have Felicia add her voice as a relatively new social worker working directly with a specific chronic disease population with clients of all ages and who recognizes the difficulties emergency departments pose for her older clients. Felicia represents the next wave of social work leaders and I look forward to hearing more from her about her insights and experiences.

  5. Editor’s note: This post was featured in the September 20, 2011, issue of Grand Rounds, hosted by Suture for a Living:

  6. Pingback: New Guidelines Show What a Geriatric Emergency Department Should Look Like | Health AGEnda

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