Care for Older Adults Living with Dementia in the Emergency Department: Informing the Development of a Clinical Care Pathway
Date
2024-06-11
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Abstract
Background: People living with dementia (PLWD) are frequent users of the emergency department (ED). PLWD experience adverse outcomes in the ED at higher rates than older adults without dementia, and care partners play a vital role in supporting them. While there is some evidence that exists regarding best practices in caring for PLWD in the ED, there are gaps in evidence on the experiences of caring for PLWD in ED and implementing best practices from the view of healthcare providers (HCPs). Objectives: The objectives of this thesis were to (1) synthesize barriers and facilitators to care for PLWD in the ED through the perspective of care partners as well as HCP perceptions of care partner roles within the ED, and (2) explore barriers and facilitators to care through the perspective of HCPs. Methods: A systematic review and meta-synthesis were conducted following the Joanna Briggs Institute Manual for Evidence Synthesis to synthesize care partner perspectives and roles regarding care for PLWD in the ED. Semi-structured interviews with HCPs were used to directly understand experiences in caring for PLWD in the ED. Results: Care partners and HCPs reported similar barriers and facilitators to care for PLWD in the ED. Key barriers to care included gaps in primary care, the ED environment, and lack of dementia specific guidance and training. Key facilitators included the importance of care partner and patient involvement, and communication and collaboration among care teams. Conclusion: The findings of this study inform the development of interventions that target behavior change and promote dementia friendly EDs. Key implications highlighted in this study include education and training, staffing and environmental changes, and care guidance and policy implementation.
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Keywords
Dementia, Emergency Department, Geriatrics
Citation
Jelinski, D. C. (2024). Care for older adults living with dementia in the emergency department: informing the development of a clinical care pathway (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.