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Background:
There is an increase in the number of frail elderly patients presenting to the emergency department. Diagnosis and treatment for this patient group is challenging due to multimorbidity, a-typical presentation and polypharmacy and requires specialised knowledge and competencies from healthcare professionals. We aim to explore the needs...
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Citations
... Although the ED plays a crucial role in the healthcare of older adults, the traditional design and busy environment of an ED does not suit the needs of the older adult and their multi co-morbidities [3]. Older adults who present to ED often have multiple health conditions and take multiple medications which increase their care needs [4]. These needs include physical, psychological, and cognitive decline, as well as vision or hearing loss, as a result interactions with healthcare professionals need to be slower and more accommodating [4]. ...
... Older adults who present to ED often have multiple health conditions and take multiple medications which increase their care needs [4]. These needs include physical, psychological, and cognitive decline, as well as vision or hearing loss, as a result interactions with healthcare professionals need to be slower and more accommodating [4]. Due to the busy nature of the ED and tendency amongst older adults to utilise emergency services more frequently and require additional resources, this cohort are at a higher risk of experiencing negative health outcomes compared to the general adult population [5]. ...
... Some of the signi cant issues highlighted by older people's experience of the ED include prolonged waiting times, unpleasant waiting conditions, such as lying on trolleys, crowded waiting areas, poor communication, lack of privacy and inadequate provisions of food, water and personal care [3,7]. In addition older adults experience bleakness in the ambience of the ED (Netherlands in 2021) as well as experiencing feeling vulnerable due to ED speci c issues; inability to have personal belongings or clothing in the ED, having no sense of time, and feeling overwhelmed with numerous questions from different healthcare professional [4]. Older adults and their families emphasise the importance of having a family member accompany them in the ED to provide assistance with mobility, cognitive or sensory issues as these needs are not always met due to the busy nature and understa ng of the ED environment. ...
Background
The COVID-19 pandemic resulted in a decrease in emergency department (ED) visits, particularly among older adults. The objective of this study is to explore the experiences of older adults attending the ED during COVID-19.
Methods
The study utilised a qualitative descriptive approach as part of a larger mixed-methods study. Data were collected at five different ED’s in Ireland, which represented both urban and rural populations. The participants were all aged over 65. Semi-structured phone interviews were conducted 10 days after attending the ED and the interviews were audio-recorded. The interviews were transcribed and imported to NVivo software, and the data was analysed using reflexive thematic analysis.
Results
16 interviews were conducted with older adults over 65. Three themes emerged following thematic analysis (1) Complexity of decision making regarding the ED attendance (2) Quality and timeliness of care in the ED (3) Communication with and empathy towards healthcare staff in the ED. The COVID-19 pandemic had a significant impact on the decision-making process and pathway for older adults seeking emergency medical care. Despite the challenges, older adults reported a positive experience in the ED. This was attributed to improved conditions, including shorter triage waiting times and the implementation of COVID-19 protocols. Participants demonstrated resilience and expressed gratitude for the care they received. However, for some participants it was noted there was a reluctance to express any dissatisfaction or complain about the care they received while in the ED. The study also highlighted concerns regarding discharge information and follow-up care for the older adult.
Conclusion
The findings demonstrate that ED healthcare providers provided quality and timely care to older adults in the ED during COVID-19. However, the need for clear communication and information sharing from healthcare providers on ED discharge and across transitions of care was highlighted as an area needing improvement.
