Case Management

The Baby Boom generation is aging, is your emergency department ready to meet its needs?

Case Management Insider, February 24, 2015

The volume of older adult patients are projected to increase from 13% to 25% in the 65-plus age group and from 1.5% to 5% in the 85-plus age group, according to Joan Michelle Moccia, MSN, RN, ANP-BC, CCRN, and Ann Marie Hill, MSW, LICSW, contributors to HCPro’s Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition.

This means your ED needs to adapt to meet the needs of older adult patients, according to Moccia and Hill.
Elderly patients are more physically vulnerable than other patients, and managing their needs can be more complex. Sometimes they may have unusual presentation for certain conditions, making it harder for clinicians to do diagnose.
“The traditional ED care delivery model (i.e., rapid assessment, rapid diagnosis, rapid disposition, and task-oriented care) will need to be adapted to the needs of the older adult,” wrote Moccia and Hill.
Among the adjustments you should consider:
  • Using a more detailed screening process to spot issues that may affect a senior’s health, such as cognitive impairment, fall risk, nutritional needs, and the potential need for social support
  • Implementing a pharmacy review process to spot potential medication problems
  • Improving the physical environment, for example by using mattresses that relieve pressure, non-slip surfaces, and soft lighting
You may also want to consider care guidelines for the older adult published in March 2014 by the Members of the American College of Emergency Physicians, American Geriatrics Society, ENA, and the Society for Academic Emergency Medicine.
Read more about senior ED strategies as well as other ED case management strategies in Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition.

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