Emergency Department Care Transitions for Patients With Cognitive Impairment: A Scoping Review

Christensen, Leslie; Aggarawal, Neelum; Allore, Heather; Amy, Aloysi; Belleville, Michael; Bellolio, M.F.; Betz, Marian E.; Biese, Kevin; Brandt, Cynthia; Bruursema, Stacey; Carnahan, Ryan M.; Carpenter, Christopher S.; Carr, David B.; Chin‐Hansen, Jennie; Daven, Morgan; Degesys, Nida; Dresden, M. Scott; Dussetschleger, Jeffrey; Ellenbogen, Michael; Foster, Beverley; Gettel, Cameron J.; Gifford, Angela; Gilmore‐Bykovskyi, Andrea; Goldberg, Elizabeth M.; Han, Jin H.; Hardy, J; Hastings, S. Nicole; Hirshon, Jon Mark; Hoang, Ly; Hogan, Teresita M.; Hung, William; Hwang, Ula; Isaacs, Eric; Jaspal, Naveena; Jobe, Deb; Johnson, Jerry; Kelly, Kathleen; Kennedy, Maura; Kind, Amy J H; Leggett, Jesseca; Malone, Michael L.; Moccia, M.; Moreno, Monica; Morrow‐Howell, Nancy; Nowroozpoor, Armin; Ohuabunwa, Ugochi; Oiyemhonian, Brenda; Perry, William; Prusaczk, Beth; Resendez, Jason; Rising, Kristen; Sano, Mary; Savage, Bob; Shah, Manish N.; Suyama, Joe; Swartzberg, Jeremy; Taylor, Zachary; Tolia, Vaishal; Vann, Allan S.; Webb, Thompson; Weıntraub, Sandra

doi:10.1016/j.jamda.2022.01.076

Cited by 24 publications

(38 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After an ED visit, PLWCI are at increased risk of adverse events, including functional decline, hospitalization, and mortality. 2 , 3 , 5 , 6 , 7 , 8 , 9 The experiences of care partners have been more greatly described during the post‐hospitalization care transition, 10 , 11 , 12 yet little is known from the care partner's perspective regarding the ED care transition.…”

Section: Introductionmentioning

confidence: 99%

“…14 Recent ED‐centric initiatives, as part of the Geriatric Emergency care Applied Research 2.0 Network – Advancing Dementia Care, 15 , 16 , 17 , 18 identified the need for the development of patient‐ and care partner‐reported outcome measures that capture what matters most to stakeholders during ED care transitions. 6 , 19 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment

Gettel

Serina

Uzamere

et al. 2022

A&D Transl Res & Clin Interv

Self Cite

View full text Add to dashboard Cite

INTRODUCTION After emergency department (ED) discharge, persons living with cognitive impairment (PLWCI) and their care partners are particularly at risk for adverse outcomes. We sought to identify the barriers experienced by care partners of PLWCI during ED discharge care transitions. METHODS We conducted a qualitative study of 25 care partners of PLWCI discharged from four EDs. We used the validated 4AT and care partner‐completed AD8 screening tools, respectively, to exclude care partners of older adults with concern for delirium and include care partners of older adults with cognitive impairment. We conducted recorded, semi‐structured interviews using a standardized guide, and two team members coded and analyzed all professional transcriptions to identify emerging themes and representative quotations. RESULTS Care partners’ mean age was 56.7 years, 80% were female, and 24% identified as African American. We identified four major barriers regarding ED discharge care transitions among care partners of PLWCI: (1) unique care considerations while in the ED setting impact the perceived success of the care transition, (2) poor communication and lack of care partner engagement was a commonplace during the ED discharge process, (3) care partners experienced challenges and additional responsibilities when aiding during acute illness and recovery phases, and (4) navigating the health care system after an ED encounter was perceived as difficult by care partners. DISCUSSION Our findings demonstrate critical barriers faced during ED discharge care transitions among care partners of PLWCI. Findings from this work may inform the development of novel care partner‐reported outcome measures as well as ED discharge care transition interventions targeting care partners.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment

Gettel

Serina

Uzamere

et al. 2022

A&D Transl Res & Clin Interv

Self Cite

View full text Add to dashboard Cite

show abstract

“…14 Recent ED-centric initiatives, as part of the Geriatric Emergency care Applied Research 2.0 Network -Advancing Dementia Care, 15 identified the need for the development of patient-and care partner-reported outcome measures that capture what matters most to stakeholders during ED care transitions. 6,16 As a first step towards developing a novel care partner-reported outcome measure, we sought to assess the barriers experienced by care partners of PLWCI during ED discharge care transitions. A greater understanding of the ED discharge care transition, as experienced by care partners of PLWCI, will provide new insights into ways in which the ED discharge process can be improved.…”

Section: Introductionmentioning

confidence: 99%

“…14 Recent ED-centric initiatives, as part of the Geriatric Emergency care Applied Research 2.0 Network – Advancing Dementia Care, 15 identified the need for the development of patient- and care partner-reported outcome measures that capture what matters most to stakeholders during ED care transitions. 6,16…”

Section: Introductionmentioning

confidence: 99%

Emergency department care transition barriers: a qualitative study of care partners of older adults with cognitive impairment

Gettel¹,

Serina

Uzamere³

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

INTRODUCTION: After emergency department (ED) discharge, persons living with cognitive impairment (PLWCI) and their care partners are particularly at risk for adverse outcomes. We sought to identify the barriers experienced by care partners of PLWCI during ED discharge care transitions. METHODS: We conducted a qualitative study of 25 care partners of PLWCI discharged from four EDs. We used the validated 4AT and care partner-completed AD8 screening tools, respectively, to exclude care partners of older adults with concern for delirium and include care partners of older adults with cognitive impairment. We conducted recorded, semi-structured interviews using a standardized guide, and two team members coded and analyzed all professional transcriptions to identify emerging themes and representative quotations. RESULTS: Care partners mean age was 56.7 years, 80% were female, and 24% identified as African American. We identified four major barriers regarding ED discharge care transitions among care partners of PLWCI: 1) unique care considerations while in the ED setting impact the perceived success of the care transition, 2) poor communication and lack of care partner engagement was a commonplace during the ED discharge process, 3) care partners experienced challenges and additional responsibilities when aiding during acute illness and recovery phases, and 4) navigating the health care system after an ED encounter was perceived as difficult by care partners. DISCUSSION: Our findings demonstrate critical barriers faced during ED discharge care transitions among care partners of PLWCI. Findings from this work may inform the development of novel care partner-reported outcome measures as well as ED discharge care transition interventions targeting care partners.

show abstract

“…28,29 Fortunately, with support from the US National Institute on Aging, a recent series of studies has focused on this issue, resulting in separate reviews on detecting cognitive impairment and dementia in emergency department settings, 30 communication with persons with ADRD and their families, 31 optimal emergency department services for persons with ADRD, 32 and management of care transitions in persons with ADRD. 33 As in virtually all aspects of medicine, progress in improving the care of older persons is incremental and painfully slow. We should have optimism, however, regarding geriatric-friendly emergency department care, because the position of emergency departments in health services, their affiliation with the most influential health care institution (acute care hospitals), the continued increase in the proportion of patients who are older persons, and the growing embrace by emergency department providers of geriatric principles will all serve to stimulate this change.…”

mentioning

confidence: 99%

The Geriatric-Focused Emergency Department: Opportunities and Challenges

Sloane

2022

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

Emergency Department Care Transitions for Patients With Cognitive Impairment: A Scoping Review

Cited by 24 publications

References 49 publications

Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment

Emergency department care transition barriers: A qualitative study of care partners of older adults with cognitive impairment

Emergency department care transition barriers: a qualitative study of care partners of older adults with cognitive impairment

The Geriatric-Focused Emergency Department: Opportunities and Challenges

Contact Info

Product

Resources

About