Older people in the ED require more extensive assessment to determine adequate management of their presenting complaint and to arrange safe and enduring discharge planning.
Hilary Siebens and the Geriatric Emergency Medicine Task Force (SAEM) have grouped the principles of ED care of older patients into four domains. They suggest the need for assessment in each of the four domains:
Click here to view a PDF version of The Domain Management Tool. Acad Emerg Med. 2005; 12(2); 162-168.
The next four pages will work through each of these domains. While Emerg physicians usually feel most comfortable with the physical, we can help our older patients a lot by addressing the others as well.