An Approach to the Older Patient in the Emergency Department

Abstract

Older patients in the emergency department (ED) present unique diagnostic and therapeutic challenges. The ED clinicians must simultaneously evaluate and treat older adults along multiple domains: cognitive impairment, atypical presentations, functional impairment, medication management, trauma and falls, and end-of-life care. This article reviews these domains and suggests strategies for a more comprehensive, patient-centered ED approach to older patients. Incorporating assessment of these domains into the ED process improves patient outcomes, provider satisfaction, and ED flow.

Keywords: Atypical presentation; Cognitive impairment; Emergency department palliative care; Functional assessment; Geriatric emergency department; Geriatric medication reconciliation.