Adapting Emergency Care for Persons Living With Dementia: Results of the Geriatric Emergency Care Applied Research Network Scoping Review and Consensus Conference

Patient‐reported outcome measure use among older adults after emergency department care: A systematic review

“…Before implementation can occur, we believe a multidisciplinary consensus effort is a necessary next step to identify which PROMs should be measured and at which time points are most crucial to assess after emergency care in the older adult population. As performed previously within emergency medicine, 92–94 this effort would also be critical in identifying situations and populations in which the potential disadvantages of PROM (e.g., collection difficulty, validation in non‐ED settings) use outweigh the benefits as well as their implementation into regular care. Logistically, to abate continued variation in outcome assessments within geriatric emergency studies, we believe an Utstein‐style task force or conference would be beneficial to develop guidelines for uniformly selecting outcomes of most relevance under specific situations and populations 95,96 …”

Recurrent emergency department visits among persons living with dementia: Bending the curve

“…Work by Geriatric Emergency Care Applied Research Network 2.0—Advancing Dementia Care (GEAR 2.0‐ADC), a National Institutes of Health (NIH)‐funded program to advance the science supporting emergency care for PLWD, can assist EDs hoping to implement these practices. GEAR 2.0‐ADC developed a workgroup of transdisciplinary individuals, including PLWD and their care partners, geriatricians, social workers, nurses, emergency physicians, researchers, and others 3 . (see Figure 1).…”

“…GEAR 2.0-ADC developed a workgroup of transdisciplinary individuals, including PLWD and their care partners, geriatricians, social workers, nurses, emergency physicians, researchers, and others. 3 (see Figure 1). Through a rigorous process, they identified and prioritized research gaps in the emergency care of PLWD.…”

The Geriatric-Focused Emergency Department: Opportunities and Challenges

“…Of all aspects of geriatric emergency department care, perhaps the most need is for system change related to care of persons with Alzheimer's disease and related dementias (ADRD), and the research to guide that change. 28,29 Fortunately, with support from the US National Institute on Aging, a recent series of studies has focused on this issue, resulting in separate reviews on detecting cognitive impairment and dementia in emergency department settings, 30 communication with persons with ADRD and their families, 31 optimal emergency department services for persons with ADRD, 32 and management of care transitions in persons with ADRD. 33 As in virtually all aspects of medicine, progress in improving the care of older persons is incremental and painfully slow.…”

“…What is needed is more collaboration between hospitals, emergency departments, long-term care settings, and other outpatient providers; increased resources and activity around staff training in geriatric principles; and more research in this understudied and critical area of medical care. Incorporation of elements of geriatric assessment into routine emergency department practice around such issues as frailty assessment, 14e17 and tailoring of service delivery to persons with high frailty scores 18 Prognosis, risk, and functional trajectories of older persons who present for emergency care 19,20 Who, when, and under what circumstances to conduct diagnostic testing 21 Geriatric-specific guidelines for medication use 14 Appropriate use of emergency departments by long-term care facilities, and improved methods of acute care in the facility 13,22e25 Under what circumstances and how best to fold in discussion of and decision making regarding limitation of treatment, advance directives, and palliative care 26e28 Care of persons with Alzheimer's disease and related dementias in emergency department settings 29…”