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. 2022 Aug;23(8):1313.e15-1313.e46.
doi: 10.1016/j.jamda.2022.02.024.

Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review

Christopher R Carpenter  1 , Jesseca Leggett  2 , Fernanda Bellolio  3 , Marian Betz  4 , Ryan M Carnahan  5 , David Carr  6 , Michelle Doering  7 , Jennie Chin Hansen  8 , Eric D Isaacs  9 , Deborah Jobe  10 , Kathleen Kelly  11 , Nancy Morrow-Howell  12 , Beth Prusaczyk  13 , Bob Savage  14 , Joe Suyama  15 , Allan S Vann  16 , Kristin L Rising  17 , Ula Hwang  18 , Manish N Shah  19 ; GEAR 2.0-ADC Network
Collaborators, Affiliations

Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review

Christopher R Carpenter et al. J Am Med Dir Assoc. 2022 Aug.

Abstract

Objectives: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research.

Design: Systematic scoping review.

Settings and participants: PLWD and their care partners in the ED setting.

Methods: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized.

Results: From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication.

Conclusions and implications: Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.

Keywords: Dementia; communication; decision making; emergency medicine; patient participation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Multi-level Complexities of Emergency Department Cmunication and Decision-Making with Persons Living with Dementia.
See this image and copyright information in PMC

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