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Apr 2025

9m 45s

Episode 208: Geriatric Emergency Medicin...

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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

Download One Comment 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