Using volunteers to improve the experience of older patients in the emergency department

Abstract

Objectives The Maximizing Aging Using Volunteer Engagement in the Emergency Department (MAUVE + ED) program connects specially trained volunteers with older patients whose personal and social needs are not always met within the busy ED environment. The objective of this study was to describe the development and implementation of the MAUVE + ED program. Methods Volunteers were trained to identify and approach older patients at risk for adverse outcomes, including poor patient experience, and invite such patients to participate in the program. The program is available to all patients >65 years, and those with confusion, patients who were alone, those with mobility issues, and patients with increased length of stay in the ED. Volunteers documented their activities after each patient encounter using a standardized paper-based data collection form. Results Over the program's initial 6-month period, the MAUVE + ED volunteers reported a total of 896 encounters with 718 unique patients. The median time (interquartile range [IQR]) a MAUVE volunteer spent with a patient was 10 minutes (IQR = 5, 20), with a range of 1 to 130 minutes. The median number of patients seen per shift was 7 (IQR = 6, 9), with a range of 1 to 16 patients per shift. The most common activities the volunteer assisted with were therapeutic activities/social visits (n = 859; 95.9%), orientation activities (n = 501; 55.9%), and hydration assistance (n = 231; 25.8%). The least common were mobility assistance (n = 36; 4.0%), and vision/hearing assistance (n = 13; 1.5%). Conclusions Preliminary data suggest the MAUVE + ED volunteers were able to provide additional care to older adults and their families/carers in the ED.

Self-reported health and life satisfaction in older emergency department patients: sociodemographic, disease-related and care-specific associated factors

“…In order to improve patient experience in the ED, the use of additional personnel might be promising in addressing the social and personal needs of older ED patients who are at risk of adverse outcomes. This may include offering support for unaccompanied patients or to those with hearing, visual or cognitive impairments [ 11 ] or offering interdisciplinary support for patients with social needs [ 46 ].…”

Family members' perceptions of older person discharge from emergency departments

“…Emergency nurses have a professional, legal, ethical and moral obligation to provide care for vulnerable populations such as the older person (Considine et al, 2018) and need to value and advocate for person‐centred care for older people to optimise their recovery trajectory. The solution may be to develop and test alternative or innovative models of care, such as the volunteer support workers, that accommodate the delivery of comfort and basic care needs during ED surge demands (Ellis et al, 2020).…”

Low investment non-pharmacological approaches implemented for older people experiencing responsive behaviours of dementia

“…These types of activities are not personally meaningful to an individual compared to tailored therapeutic activities. In an emergency department older adults and families have been found to be provided with additional care through tailored therapeutic activities including social visits and supplied activities (e.g., books, puzzles, crosswords, magazines) (Ellis et al., 2020). Despite the promising potential of therapeutic activities in acute care settings, many barriers in acute care settings exist (e.g., inadequate staffing, lack of dementia care education) leading to some nurses to resort to administering chemical or physical restraints (Digby et al., 2016).…”