Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine

J A Lucke^#¹, S P Mooijaart^#², P Heeren^{3

4

5}, K Singler^{6

7}, R McNamara⁸, T Gilbert⁹, C H Nickel¹⁰, S Castejon¹¹, A Mitchell¹², V Mezera¹³, L Van der Linden^{14

15}, S E Lim¹⁶, A Thaur¹⁷, M A Karamercan¹⁸, L C Blomaard², Z D Dundar¹⁹, K Y Chueng²⁰, F Islam²¹, B de Groot^#²², S Conroy^#²³

Affiliations

¹ Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands. jlucke@spaarnegasthuis.nl.
² Department of Internal Medicine, Section on Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
³ Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
⁴ Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
⁵ Research Foundation Flanders, Brussels, Belgium.
⁶ Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private, Medical University, Nuremberg, Germany.
⁷ Institute for Biomedicine of Ageing, Friedrich-Alexander-University, Erlangen-Nuremberg, Erlangen, Germany.
⁸ Department of Emergency Medicine, St. Vincent's University Hospital, Dublin, Ireland.
⁹ Department of Geriatric Medicine, Lyon-Sud University Hospital, Lyon, France.
¹⁰ Emergency Medicine, University Hospital Basel, Basel, Switzerland.
¹¹ Department of Geriatrics and Palliative Care, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.
¹² Department of Emergency Medicine, Sligo University Hospital, Sligo, Ireland.
¹³ Geriatric Center, Pardubice Hospital, Pardubice, Czech Republic.
¹⁴ Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
¹⁵ Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
¹⁶ Academic Geriatric Medicine, University of Southampton, Southampton, UK.
¹⁷ Department of Emergency Medicine, Guy's and St.Thomas' NHS Foundation Trust, London, UK.
¹⁸ Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey.
¹⁹ Department of Emergency Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
²⁰ Accident and Emergency Department, United Christian Hospital, Kwun Tong, Hong Kong.
²¹ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
²² Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands.
²³ Geriatric Medicine, MRC Unit for Lifelong Health and Ageing at UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK.

^# Contributed equally.

PMID: 34738224
PMCID: PMC8568564
DOI: 10.1007/s41999-021-00578-1

Review

Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine

J A Lucke et al. Eur Geriatr Med. 2022 Apr.

. 2022 Apr;13(2):309-317.

doi: 10.1007/s41999-021-00578-1. Epub 2021 Nov 5.

Authors

Affiliations

¹ Department of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands. jlucke@spaarnegasthuis.nl.
² Department of Internal Medicine, Section on Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
³ Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
⁴ Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
⁵ Research Foundation Flanders, Brussels, Belgium.
⁶ Department of Geriatrics, Klinikum Nürnberg, Paracelsus Private, Medical University, Nuremberg, Germany.
⁷ Institute for Biomedicine of Ageing, Friedrich-Alexander-University, Erlangen-Nuremberg, Erlangen, Germany.
⁸ Department of Emergency Medicine, St. Vincent's University Hospital, Dublin, Ireland.
⁹ Department of Geriatric Medicine, Lyon-Sud University Hospital, Lyon, France.
¹⁰ Emergency Medicine, University Hospital Basel, Basel, Switzerland.
¹¹ Department of Geriatrics and Palliative Care, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain.
¹² Department of Emergency Medicine, Sligo University Hospital, Sligo, Ireland.
¹³ Geriatric Center, Pardubice Hospital, Pardubice, Czech Republic.
¹⁴ Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
¹⁵ Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
¹⁶ Academic Geriatric Medicine, University of Southampton, Southampton, UK.
¹⁷ Department of Emergency Medicine, Guy's and St.Thomas' NHS Foundation Trust, London, UK.
¹⁸ Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey.
¹⁹ Department of Emergency Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.
²⁰ Accident and Emergency Department, United Christian Hospital, Kwun Tong, Hong Kong.
²¹ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
²² Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands.
²³ Geriatric Medicine, MRC Unit for Lifelong Health and Ageing at UCL, 5th Floor, 1-19 Torrington Place, London, WC1E 7HB, UK.

^# Contributed equally.

PMID: 34738224
PMCID: PMC8568564
DOI: 10.1007/s41999-021-00578-1

Abstract

Purpose: Despite the rapidly expanding knowledge in the field of Geriatric Emergency Medicine in Europe, widespread implementation of change is still lacking. Many opportunities in everyday clinical care are missed to improve care for this susceptible and growing patient group. The aim was to develop expert clinical recommendations on Geriatric Emergency Medicine to be disseminated across Europe.

Methods: A group of multi-disciplinary experts in the field of Geriatric Emergency Medicine in Europe was assembled. Using a modified Delphi procedure, a prioritized list of topics related to Geriatric Emergency Medicine was created. Next, a multi-disciplinary group of nurses, geriatricians and emergency physicians performed a review of recent guidelines and literature to create recommendations. These recommendations were voted upon by a group of experts and placed on visually attractive posters. The expert group identified the following eight subject areas to develop expert recommendations on: Comprehensive Geriatric Assessment in the Emergency Department (ED), age/frailty adjusted risk stratification, delirium and cognitive impairment, medication reviews in the ED for older adults, family involvement, ED environment, silver trauma, end of life care in the acute setting.

Results: Eight posters with expert clinical recommendations on the most important topics in Geriatric Emergency Medicine are now available through https://posters.geriemeurope.eu/ .

Conclusion: Expert clinical recommendations for Geriatric Emergency Medicine may help to improve care for older patients in the Emergency Department and are ready for dissemination across Europe.

Keywords: Acute care; Emergency Medicine; Frailty; Geriatric Emergency Medicine; Geriatrics; Guidelines.

PubMed Disclaimer

Conflict of interest statement

PH is holder of a PhD fellowship Granted by Research Foundation-Flanders (FWO) (1133320N). For the remaining authors, none were declared.

Figures

**Fig. 1**
Poster expert clinical recommendations on topic 2: age/frailty adjusted risk stratification. Example of a poster that can be used to educate caregivers in the ED on age and frailty adjusted risk stratification

See this image and copyright information in PMC

References

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1. Heeren P, et al. Structure and processes of emergency observation units with a geriatric focus: a scoping review. BMC Geriatr. 2021;21(1):95. doi: 10.1186/s12877-021-02029-9. - DOI - PMC - PubMed
1. La Grouw Y, Bannink D, van Hout H. Care professionals manage the future, frail older persons the past. Explaining why frailty management in primary care doesn't always work. Front Med (Lausanne) 2020;7:489. doi: 10.3389/fmed.2020.00489. - DOI - PMC - PubMed

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Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine

Affiliations

Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources