Patterns of care partner communication for persons living with dementia in the emergency department

Haimovich, Adrian D.; Gilson, Aidan; Gao, Evangeline; Chi, Ling; Gettel, Cameron J.; Schonberg, Mara A.; Hwang, Ula; Taylor, Richard A.

doi:10.17294/2694-4715.1043

Cited by 2 publications

(4 citation statements)

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“…[28] In accordance with the informants worry regarding making incorrect clinical judgements and assessments, previous research has found that dementia indeed is associated with decreased accuracy of the older patient presenting illness, [29] and that communication barriers pose risks for patients. [13,[15][16][17][18] Specifically for PLwD, whose ED visits are associated with adverse outcomes including functional decline, hospitalization, and mortality, [3,10,11,30,31] with one of the found reasons for adverse outcomes being communication barriers. [11] Indeed, PLwD are less likely to comprehend their discharge diagnosis and instructions.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…[3] In fact, nearly half of all PLwD will visit the ED in any given year, and ED visits by PLwD are associated with adverse outcomes. [3,10,11] One factor that has been attributed to this is poor communication. [11] Language barriers in healthcare have been found to result in miscommunication between the medical professional and patient, and to reduce patient safety as well as the quality of care.…”

Section: Introductionmentioning

confidence: 99%

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“You treat what you have to treat, and you don’t care as much if they understand or if they feel good about it”: Communication barriers and perceptions of moral distress among doctors in emergency departments

Brune,

Liljas

2023

Medicine

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Doctors facing communication barriers when assessing patients in emergency departments (ED) is a frequent phenomenon, as the global prevalence of dementia and migration have increased. This study aims to explore how communication barriers influence moral distress as perceived by medical doctors working at emergency departments. Twelve doctors at 2 different EDs in Stockholm, Sweden, participated. Answers on communication barriers were collected from an interview guide on moral distress. Informants’ responses were analyzed using qualitative thematic analysis. The results suggest that doctors experience moral distress when assessing patients with communication barriers due to an inability to mediate calm and safety and understand their patients, and due an increased need of resources and difficulties in obtaining consent before conducting examinations or interventions. In conclusion, communication barriers can be a cause of moral distress, which should be considered when developing tools and methods to mitigate and manage moral distress.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“You treat what you have to treat, and you don’t care as much if they understand or if they feel good about it”: Communication barriers and perceptions of moral distress among doctors in emergency departments

Brune,

Liljas

2023

Medicine

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“…Finally, patients often present to the ED feeling unwell or in pain and may prefer to focus on management of their acute medical issue or injury. There has been work into using existing data in the electronic health records to target fall risk/mobility screening to those most likely to have needs, thereby reducing the burden on ED nurses 79 . Additional validated fall risk tools such as the 4‐Stage Balance test take under a minute to perform and many GEDs have integrated fall risk evaluation and reduction programs successfully into their standard care 36 …”

Section: Ms Frameworkmentioning

confidence: 99%

Enhancing healthcare access for an older population: The age‐friendly emergency department

Lee,

Skains,

Magidson

et al. 2024

JACEP Open

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Healthcare systems face significant challenges in meeting the unique needs of older adults, particularly in the acute setting. Age‐friendly healthcare is a comprehensive approach using the 4Ms framework—what matters, medications, mentation, and mobility—to ensure that healthcare settings are responsive to the needs of older patients. The Age‐Friendly Emergency Department (AFED) is a crucial component of a holistic age‐friendly health system. Our objective is to provide an overview of the AFED model, its core principles, and the benefits to older adults and healthcare clinicians. The AFED optimizes the delivery of emergency care by integrating age‐specific considerations into various aspects of (1) ED physical infrastructure, (2) clinical care policies, and (3) care transitions. Physical infrastructure incorporates environmental modifications to enhance patient safety, including adequate lighting, nonslip flooring, and devices for sensory and ambulatory impairment. Clinical care policies address the physiological, cognitive, and psychosocial needs of older adults while preserving focus on emergency issues. Care transitions include communication and involving community partners and case management services. The AFED prioritizes collaboration between interdisciplinary team members (ED clinicians, geriatric specialists, nurses, physical/occupational therapists, and social workers). By adopting an age‐friendly approach, EDs have the potential to improve patient‐centered outcomes, reduce adverse events and hospitalizations, and enhance functional recovery. Moreover, healthcare clinicians benefit from the AFED model through increased satisfaction, multidisciplinary support, and enhanced training in geriatric care. Policymakers, healthcare administrators, and clinicians must collaborate to standardize guidelines, address barriers to AFEDs, and promote the adoption of age‐friendly practices in the ED.

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Patterns of care partner communication for persons living with dementia in the emergency department

Cited by 2 publications

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“You treat what you have to treat, and you don’t care as much if they understand or if they feel good about it”: Communication barriers and perceptions of moral distress among doctors in emergency departments

“You treat what you have to treat, and you don’t care as much if they understand or if they feel good about it”: Communication barriers and perceptions of moral distress among doctors in emergency departments

Enhancing healthcare access for an older population: The age‐friendly emergency department

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