Appropriateness of Nursing Home to Emergency Department Transitional Care for Older Adults With Dementia: A Scoping Review

Abstract

Purpose: To systematically identify knowledge patterns and gaps in the appropriateness of nursing home (NH) to emergency department (ED) transitional care for older adults with dementia.

Method: A systematic search of multiple information sources was performed from July to August 2023 using predesigned search strategies.

Results: From 13 articles, 54 identified pieces of specific care evidence were grouped into six major care domains: (1) Resource Support for Assessing Transfer Needs and Patient Status; (2) Resource Support, Shared Decision Making, and Early Advance Care Planning; (3) Standardized Multimodal Information Transfer; (4) Designated ED and NH Transition Coordinators; (5) Enhanced Interfacility Collaboration; and (6) Appropriate Transitional Care Education, Research, and Policy Beyond the Transfer Interface.

Conclusion: A comprehensive, consensus-based body of evidence is lacking. Despite person-centered, standardized, and professional resources supporting transitional care, reorienting NH cultural models remains unclear. Gaps include evidence tailored to diverse participants and contexts. Thus, a focus on policies, education, and research is required. [Journal of Gerontological Nursing, 50(9), 37-45.].