Core EM - Emergency Medicine Podcast

Episode 208: Geriatric Emergency Medicine

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We explore the expanding field of Geriatric Emergency Medicine.

Hosts:

Ula Hwang, MD
Brian Gilberti, MD

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Geriatric_Emergency_Medicine.mp3
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Tags: Geriatric
Show Notes
Key Topics Discussed
  • Importance and impact of geriatric emergency departments.
  • Optimizing care strategies for geriatric patients in ED settings.
  • Practical approaches for non-geriatric-specific EDs.
    • Challenges in Geriatric Emergency Care
    • Geriatric patients often present with:
      • Multiple chronic conditions
      • Polypharmacy
      • Functional decline (mobility issues, cognitive impairments, social isolation)
        • Adapting Clinical Approach
        • Core objective remains acute issue diagnosis and treatment.
        • Additional considerations for geriatric patients:
          • Review and caution with medications to prevent adverse reactions.
          • Address functional limitations and cognitive impairments.
          • Emphasize safe discharge and care transitions to prevent unnecessary hospitalization.
            • Identifying High-Risk Geriatric Patients
            • Screening tools:
              • Identification of Seniors at Risk (ISAR)
              • Frailty screens
              • Alignment with the “Age-Friendly Health Systems” initiative focusing on:
                • Mentation
                • Mobility
                • Medications
                • Patient preferences (what matters most)
                • Mistreatment (elder abuse awareness)
                  • Minimizing Hospital-Related Harms
                  • Involvement of multidisciplinary teams:
                    • Social workers and care managers for care transitions
                    • Geriatric-certified pharmacists for medication review
                    • Coordination with outpatient services post-discharge
                      • Implementing Geriatric Care in All EDs
                      • Basic geriatric care achievable even in resource-limited or rural EDs.
                      • Level 3 Geriatric ED Accreditation can be achieved through:
                        • Improved care transitions
                        • Staff education enhancements
                        • Age-friendly environments (comfort, nutrition, hydration)
                          • Future of Geriatric Emergency Medicine
                          • Vision: Universal integration of geriatric-focused care.
                          • Goals:
                            • Enhanced patient experience
                            • Improved care transitions
                            • Alignment of treatments with patient goals
                            • Broader enhancement of emergency care quality for all patient populations

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