Episode 208: Geriatric Emergency Medicine

We explore the expanding field of Geriatric Emergency Medicine.
Hosts:
Ula Hwang, MD
Brian Gilberti, MD



https://media.blubrry.com/coreem/content.blubrry.com/coreem/Geriatric_Emergency_Medicine.mp3



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Tags: Geriatric





Show Notes

Key Topics Discussed

* Importance and impact of geriatric emergency departments.
* Optimizing care strategies for geriatric patients in ED settings.
* Practical approaches for non-geriatric-specific EDs.

Challenges in Geriatric Emergency Care

* Geriatric patients often present with:

* Multiple chronic conditions
* Polypharmacy
* Functional decline (mobility issues, cognitive impairments, social isolation)



Adapting Clinical Approach

* Core objective remains acute issue diagnosis and treatment.
* Additional considerations for geriatric patients:

* Review and caution with medications to prevent adverse reactions.
* Address functional limitations and cognitive impairments.
* Emphasize safe discharge and care transitions to prevent unnecessary hospitalization.



Identifying High-Risk Geriatric Patients

* Screening tools:

* Identification of Seniors at Risk (ISAR)
* Frailty screens


* Alignment with the “Age-Friendly Health Systems” initiative focusing on:

* Mentation
* Mobility
* Medications
* Patient preferences (what matters most)
* Mistreatment (elder abuse awareness)



Minimizing Hospital-Related Harms

* Involvement of multidisciplinary teams:

* Social workers and care managers for care transitions
* Geriatric-certified pharmacists for medication review


* Coordination with outpatient services post-discharge

Implementing Geriatric Care in All EDs

* Basic geriatric care achievable even in resource-limited or rural EDs.
* Level 3 Geriatric ED Accreditation can be achieved through:

* Improved care transitions
* Staff education enhancements
* Age-friendly environments (comfort, nutrition, hydration)



Future of Geriatric Emergency Medicine

* Vision: Universal integration of geriatric-focused care.
* Goals:

* Enhanced patient experience
* Improved care transitions
* Alignment of treatments with patient goals
* Broader enhancement of emergency care quality for all patient populations






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