TY - JOUR
T1 - Evaluating older adults with cognitive dysfunction
T2 - A qualitative study with emergency clinicians
AU - Chary, Anita N.
AU - Castilla-Ojo, Noelle
AU - Joshi, Christopher
AU - Santangelo, Ilianna
AU - Carpenter, Christopher R.
AU - Ouchi, Kei
AU - Naik, Aanand D.
AU - Liu, Shan W.
AU - Kennedy, Maura
N1 - Publisher Copyright:
© 2021 The American Geriatrics Society.
PY - 2022/2
Y1 - 2022/2
N2 - Background: Evaluating older adults with cognitive dysfunction in emergency departments (EDs) requires obtaining collateral information from sources other than the patient. Understanding the challenges emergency clinicians face in obtaining collateral information can inform development of interventions to improve geriatric emergency care and, more specifically, detection of ED delirium. The objective was to understand emergency clinicians' experiences obtaining collateral information on older adults with cognitive dysfunction, both before and during the COVID-19 pandemic. Methods: From February to May 2021, we conducted semi-structured interviews with a purposive sample of 22 emergency physicians and advanced practice providers from two urban academic hospitals and one community hospital in the Northeast United States. Interviews lasted 10–20 min and were digitally recorded and transcribed. Interview transcripts were analyzed for dominant themes using a combined deductive–inductive approach. Responses regarding experiences before and during the pandemic were compared. Results: Five major challenges emerged regarding (1) availability of caregivers, (2) reliability of sources, (3) language barriers, (4) time constraints, and (5) incomplete transfer documentation. Participants perceived all challenges, but those relating to transfer documentation were amplified by the COVID-19 pandemic. Conclusion: Emergency clinicians' perspectives can inform efforts to support caregiver presence at bedside and develop standardized communication tools to improve recognition of delirium and, more broadly, geriatric emergency care.
AB - Background: Evaluating older adults with cognitive dysfunction in emergency departments (EDs) requires obtaining collateral information from sources other than the patient. Understanding the challenges emergency clinicians face in obtaining collateral information can inform development of interventions to improve geriatric emergency care and, more specifically, detection of ED delirium. The objective was to understand emergency clinicians' experiences obtaining collateral information on older adults with cognitive dysfunction, both before and during the COVID-19 pandemic. Methods: From February to May 2021, we conducted semi-structured interviews with a purposive sample of 22 emergency physicians and advanced practice providers from two urban academic hospitals and one community hospital in the Northeast United States. Interviews lasted 10–20 min and were digitally recorded and transcribed. Interview transcripts were analyzed for dominant themes using a combined deductive–inductive approach. Responses regarding experiences before and during the pandemic were compared. Results: Five major challenges emerged regarding (1) availability of caregivers, (2) reliability of sources, (3) language barriers, (4) time constraints, and (5) incomplete transfer documentation. Participants perceived all challenges, but those relating to transfer documentation were amplified by the COVID-19 pandemic. Conclusion: Emergency clinicians' perspectives can inform efforts to support caregiver presence at bedside and develop standardized communication tools to improve recognition of delirium and, more broadly, geriatric emergency care.
KW - COVID-19
KW - cognitive dysfunction
KW - collateral information
KW - delirium
KW - geriatric emergency medicine
UR - http://www.scopus.com/inward/record.url?scp=85120915096&partnerID=8YFLogxK
U2 - 10.1111/jgs.17581
DO - 10.1111/jgs.17581
M3 - Article
C2 - 34796476
AN - SCOPUS:85120915096
SN - 0002-8614
VL - 70
SP - 341
EP - 351
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 2
ER -