Geriatric Emergencies: A Case-Based Approach to Improving Acute Care PDF
Preview Geriatric Emergencies: A Case-Based Approach to Improving Acute Care
Lee A. Lindquist Scott M. Dresden Editors Geriatric Emergencies A Case-Based Approach to Improving Acute Care 123 Geriatric Emergencies Lee A. Lindquist • Scott M. Dresden Editors Geriatric Emergencies A Case-Based Approach to Improving Acute Care Editors Lee A. Lindquist Scott M. Dresden Northwestern University Northwestern University Feinberg School of Medicine Feinberg School of Medicine Chicago, IL Chicago, IL USA USA ISBN 978-3-030-12413-7 ISBN 978-3-030-12414-4 (eBook) https://doi.org/10.1007/978-3-030-12414-4 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of transla- tion, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimi- lar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of pub- lication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Preface When an older adult enters the emergency department, it is everyone’s hope that the best clinical care will be provided. Whether you are an emergency department provider or you bring a beloved older relative or parent to the emergency department or you are a retired clinician seeking emergent care, we all want the best care for our older adult population. Caring optimally for older adults requires specific knowl- edge of geriatrics and aging. Each older adult that we see prepares us to take better care of the next older adult. With this premise, we sought to put together cases of older adult stories to help clinicians – and anyone else interested in improving the care of older adults – to learn from. Many of these cases arose from Geriatric Emergency Departments – from Northwestern Medicine in Chicago to VA Health Systems in Cleveland – where dedicated geriatrics training of the next generation of emergency department is occurring. It is at these top-rated academic geriatrics programs where health systems across the nation are sending their emergency department staff to participate in intensive geriatrics educa- tion with a goal to establish Geriatric Emergency Departments. Geriatric Emergency Departments are the next wave of treating older adults, and they start with health- care providers who understand the tenets of geriatrics. We hope that this book will help hone provider geriatrics skills and learn better what needs to be done in the emergency department. We the authors and editors want to thank all of our fami- lies, friends, and supporters who assisted us with this book. vi Preface Whether it be from proofreading our work to watching our children while we work, we are truly thankful. We hope that in the future, when we ourselves become older adults, the best geriatrics care will be received no matter where the emer- gency happens. Chicago, IL, USA Lee A. Lindquist Scott M. Dresden Contents 1 Growing Older in the Emergency Department . . . . . 1 Lee A. Lindquist and Paul A. Nelson 2 Components of an Effective Geriatric Emergency Department . . . . . . . . . . . . . . . . . . . . . . . 11 Scott M. Dresden 3 Cognitive Impairment in the ED . . . . . . . . . . . . . . . . 39 Jill M. Huded and Todd I. Smith 4 Syncope in a Rural Emergency Department Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Lucy Morse and Lee A. Lindquist 5 ER Referrals and Hospitalizations from Post-acute and Long-Term Care Facilities. . . . 77 Fernanda Heitor 6 Can Home Visits Make a Difference to Emergency Department Visits? “I will just stop by his place on the way home: Who knew it would be a journey?” . . . . . . . . . . . . . . . . . . . . . . . . 103 Dwayne Dobschuetz and Katherine O’Brien 7 Medication Errors in Aging Adults: A Case- Based Approach to Medication Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Abbie Lyden and Katherine Allen 8 Pain, Opioid Use, and Palliative Care of Older Adults in the Emergency Department . . . . . . . . . . . 139 William P. Burns viii Contents 9 Acute Mental Status Changes and O ver-the- Counter Medications in Older Adults . . . . . . . . . . . . . . . . . . . . 157 Katherine M. Hunold 10 Identifying Fall Risk in the Emergency Department . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173 Chirley M. Rodriguez 11 Capacity, Advanced Planning, and Buying Time . . . 185 Hashim Q. Zaidi Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209 Contributors Katherine Allen, PharmD Department of Pharmacy, Department of Emergency Medicine, Northwestern Medicine, Chicago, IL, USA William P. Burns, MD Department of Emergency Medicine, University of Wisconsin, Madison, WI, USA Division of Palliative Care, Department of Medicine, University of Wisconsin, Madison, WI, USA Dwayne Dobschuetz, APRN, MSN Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern Medicine Home Care Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Scott M. Dresden, MD, MS Department of Emergency Medicine, Northwestern Medicine, Center for Healthcare Studies, Buehler Center for Health Policy and Economics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Fernanda Heitor, MD Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Northwestern Medical Group, Chicago, IL, USA Jill M. Huded, MD Medicine Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA x Contributors Katherine M. Hunold, MD Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA Lee A. Lindquist, MD, MPH, MBA Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Abbie Lyden, PharmD, BCPS Northwestern Medicine, Department of Pharmacy, Department of Emergency Medicine, Department of Pharmacy Practice, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA Lucy Morse, BS, MD Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Paul A. Nelson, B. Arch Chicago, IL, USA Katherine O’Brien, MD Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern Medicine Home Care Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Chirley M. Rodriguez, MD Allegheny General Hospital, Pittsburgh, PA, USA Todd I. Smith, MD, FACP, FHM Medicine Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA Hashim Q. Zaidi, MD Department of Emergency Medicine, Northwestern Memorial Hospital, Chicago, IL, USA Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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