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Hospital emergency rooms failing to meet seniors' needs: study

Tuesday, August 20, 2013   by: Staff



WATERLOO, ON (August 20, 2013) - Emergency departments are not meeting the needs of senior citizens, according to a new international study published in the Annals of Emergency Medicine.

The study, which looked at patients over the age of 75 in emergency departments in Australia, Belgium, Canada, Germany, Iceland, India and Sweden, found that seniors have very different needs than the general population - needs that are not being addressed well by current clinical practices or emergency department designs.

"The majority of older patients attending emergency departments are frail and dependent on others for help. They have distinct and often complex needs," said Professor John Hirdes from the University of Waterloo's School of Public Health and Health Systems and senior fellow of interRAI, the organization behind the study. "Traditional emergency departments are not equipped for geriatric assessment and intervention because they were designed and staffed to respond to severe acute illnesses and injuries."

"When you bring an already frail person into a chaotic hospital environment like an emergency department, the risk for misdiagnosis or inadequate care is high. There often aren't the trained specialists available, so geriatric conditions like delirium can be misdiagnosed as dementia," said Professor Hirdes.

The study found that 78 percent of seniors arriving at emergency departments were dependent in activities of daily living, had a cognitive problem or had fallen in the past 90 days.

The pattern was consistent across all nations.

Twenty-six percent of seniors presenting at emergency departments displayed cognitive impairment, a six percent increase prior to arrival.

In 16 percent of patients there was evidence of an acute change in mental state, suggesting the presence of delirium.

"We need to think about managing seniors in emergency rooms in a different way," said Professor Hirdes.

Staff training in geriatric care, changes in care delivery protocols and specialized department layouts with easily accessible facilities and sound management, would allow emergency rooms to better meet the needs of senior citizens.

"The absence of life-threatening injuries doesn't mean seniors and their families don't have serious health needs," said Professor Hirdes. "There is often the sense that seniors are wasting resources in emergency departments, which is simply untrue. Refining approaches to managing older patients would allow hospitals to meet the needs of the aging population while still providing traditional services to high-risk patients."

The findings are part of the most extensive international study on the characteristics and outcomes of older emergency department patients.

Data were collected using a geriatric assessment tool developed by Waterloo researchers in collaboration with interRAI.

The study measured the physical function and cognition of 2,282 patients in 13 emergency departments in seven nations, including Canada.

The Canadian arm of the study was led by Professor Hirdes and Andrew Costa, a PhD graduate in aging, health and well-being.

Journal reference.

About the University of Waterloo

In just half a century, the University of Waterloo, located at the heart of Canada's technology hub, has become one of Canada's leading comprehensive universities with 35,000 full- and part-time students in undergraduate and graduate programs.

Waterloo, as home to the world's largest post-secondary co-operative education program, embraces its connections to the world and encourages enterprising partnerships in learning, research and discovery.

In the next decade, the university is committed to building a better future for Canada and the world by championing innovation and collaboration to create solutions relevant to the needs of today and tomorrow.

For more information about Waterloo, please visit  here.


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TFinn 8/20/2013 10:37:53 AM Report

No sh** .....!!
asp 8/20/2013 12:15:24 PM Report

The emergengy room in our city does a fine job. Recently I was there and they took care of me better then the nurse on the tird B wing. The elderly people that I saw were taken care of, actually the staff in the emergency room have alot to put up with. The money used for these studies could go to some other program, instead of telling everyone what they are doing wrong.I would like to say that the PSW do most of the patient care, and the nurses on that floor are to stuck on themselves and they seemed to be angry.
SooTodayer 8/20/2013 12:51:45 PM Report

Well at least you had a good experience, I've had two friends go to emerg and both had a nightmare of a time.
The emerg isn't only failing seniors, so is the long term care needed for many of them. It's a disaster, and they don't deserve it.
Oldie Goldie 8/20/2013 1:17:38 PM Report

Our Hospital triages all who report to Emerg. and those who suffer an injury are fast-tracked. That is fine but, I believe, that anyone over 70 years old should be fast-tracked too if seniors are to get the Service that they have earned over their years of paying Health Payments.
Oldie Goldie 8/20/2013 1:27:11 PM Report

Long-Term care for seniors is in a shambles. The new Long-Term care home was completely filled with those who were already in Long-Term care and those in the Long-Term care at the old Plummer Hospital were put into the new Hospital. So there was no extra beds provided for, at least, 100 or more on the waiting lists.

Just recently there was a report that it costs $ 800 a day for a Hospital Bed but only about $ 150 for a Long-Term care bed.

It only makes economic sense to build more Long-Term Care beds but Politicians seem to have a penchant for not saving money even when the proof is provided.
asp 8/20/2013 2:53:54 PM Report

You know we need more nursing homes in this city. People are being put in the hospital instead of a nursing homes because there are no beds free.
geterdun 8/20/2013 3:41:48 PM Report

The problem is the government is a joke! They are more concerned with giving their friends free cash and wasting tax money on themselves then they are of taking care of those who pay their ridiculous wages. Greedy politicians stealing our money! And you wonder what the problem is? Please ! They should all be fired!!!
harshbee 8/20/2013 7:53:00 PM Report

the emergency room is pretty fair, depending what time of day you go there,but i've been there when there was only like two people in the fast-track ,, yet the nurses would sit at the desk chatting away ,and and one lady was in so much pain , that she was crying, the doctors would walk by and not even look in the waiting room. now comes the part where they send you to sudbury , and its always twice, first for the interview, then weeks and weeks later ,, you have to go back for your surgery. i mean if you're over 65 and are experiencing pain and your life is in the balance, why not bring qualified surgeons to your home town ,, i'll tell you why (MONEY) not the patients ,,thats the last thing on their minds,i'm beginning to think "population control here", its a sad situation .
terbum2 8/20/2013 11:47:54 PM Report

You think that's bad I walked into emerg. and I had a Major Heart Attack and the receptionist asked me if I had taken a number? lmao thank God the head nurse heard this and off I went to Sudbury for major heart surgery
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