Ula Hwang, a full professor at NYU and a trailblazer in geriatric emergency medicine, discusses the growing importance of specialized emergency care for older adults. She highlights the unique challenges faced by these patients, such as polypharmacy and functional decline. The conversation delves into essential screening tools to identify at-risk seniors and emphasizes customized care strategies. Ula also covers the need for multidisciplinary teams in emergency settings to ensure safe transitions and optimal outcomes for geriatric patients.
Emergency physicians need to adapt their approaches for geriatric patients by addressing unique challenges like functional limitations and polypharmacy.
The establishment of geriatric emergency departments introduces standardized care protocols that improve patient comfort and outcomes for older adults.
Deep dives
Optimizing Care for Geriatric Patients
Emergency physicians must adapt their clinical approach when treating geriatric patients, who often present unique challenges such as multiple chronic conditions and polypharmacy. While the core aim remains diagnosing and treating the acute issue, additional factors like functional limitations and cognitive impairments require more thoughtful consideration. For instance, taking the time to address these aspects can result in safer discharges, helping patients avoid unnecessary hospitalizations. This approach emphasizes a balance between efficiency in the ED and the complexities of geriatric care, ultimately prioritizing patient safety and quality of life.
Identifying High-Risk Geriatric Patients
To effectively manage geriatric patients, emergency departments are increasingly using frailty screens, such as the clinical frailty score, to identify patients at higher risk. These tools assess a patient’s mobility and overall condition, guiding healthcare providers in tailoring their approach to each individual. Furthermore, incorporating the 'four or five M’s'—mentation, medications, mobility, what matters, and elder mistreatment—enhances the evaluation process, ensuring a comprehensive understanding of the patient's needs. This multi-faceted framework allows for more informed decision-making and encourages discussions about patient goals and preferences.
Components of Geriatric Emergency Departments
The development of geriatric emergency departments (GERI-EDs) is fostering a new standard in emergency care focused on the elderly population. Key components include standardized protocols for care transitions, proper staffing, and environmental modifications to enhance patient comfort. The GERI-ED accreditation program sets benchmarks for emergency departments, encouraging them to integrate geriatric care standards, regardless of their size or resources. As the demand for geriatric care increases, the hope is that these practices will become commonplace across all emergency settings, improving outcomes for older patients.