Older patients need special care in emergency departments

A large international study led by the Centre for Research in Geriatric Medicine at The University of Queensland suggests that emergency departments should focus their attention on the needs of frail older people.

The collaborative study examined the needs and outcomes of 2282 older patients in 13 emergency departments across seven countries.

Lead researcher Professor Len Gray said the study was the first to demonstrate that issues with older patients attending emergency departments were the same all over the world.

"Older patients have complex problems before they arrive at emergency departments and even more complicated needs once they get there," Professor Gray said.

"Dependence on others and geriatric illnesses, such as cognitive impairment and mobility problems, affect the majority of older emergency patients across a wide range of nations with different health systems and cultural contexts.

"Older patients require specialised care to avoid missed diagnoses, to prevent complications associated with frailty, and to ensure best care and appropriate discharge planning.

"Adjustments could include simple changes in furniture or lighting, or more complex changes requiring staff to undertake specialised training, or the purchase of equipment to minimise risk.

"Many hospitals are now designing sections of the emergency department to cater specifically for frail older patients."

The study tracked the progress of patients aged over 75, and was conducted in emergency departments across Australia, Belgium, Canada, Germany, Iceland, India and Sweden.

Researchers examined medical records, spoke with hospital staff and interviewed patients about their cognitive and physical function.

Overall, 48 per cent had a geriatric syndrome before becoming unwell, increasing to 78 per cent in the emergency department – an increase that was consistent across countries.

The study was conducted from the Princess Alexandra and Mater Hospitals in Brisbane, and was funded in part by the Princess Alexandra Hospital Foundation.

Study findings are published online in the Annals of Emergency Medicine.