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Emergency departments need to do more to support older adults with cognitive impairment
Date:7/6/2011

More needs to be done to improve the care that older adults with cognitive impairment - including dementia and delirium - receive when they visit hospital emergency departments, according to a research review in the July issue of the Journal of Advanced Nursing.

Researchers from the University of Alberta reviewed 15 studies published between 1994 and 2009, covering 4,431 patients from the USA, Canada, Australia, Italy, New Zealand and Israel.

They point out that a large proportion of older adults over 65 visit emergency departments (EDs) in high-income countries. For example, in North America, older adults visit EDs more than any other age group, are more likely to request an ambulance and receive more acute interventions on arrival. Similar trends have been observed in New Zealand, Australia, Great Britain and other European countries.

Despite this, there is little research into how people with cognitive impairment - who can account for up to 40 per cent of older ED patients - are assessed, treated or supported during their visit.

"Older patients with cognitive impairment are unable to make decisions for themselves or function independently when they visit an emergency department" explains lead author Dr Belinda Parke, Assistant Professor in the University's Faculty of Nursing. "They tend to be more helpless, demand special attention and fail to co-operate, posing many challenges for healthcare staff during admission, assessment and treatment.

"But, as one of the studies we reviewed rightly points out, there is a profound difference between saying that a patient is difficult and realising that patient care is difficult."

Key findings of the review include:

  • Most of the studies defined older patients as 65 plus, with the starting point for inclusion varying from 64 to 75 years of age.

  • Delirium was the most common cognitive impairment, but was poorly recognised, diffic
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Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell
Source:Eurekalert

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