It is clear that some of these assessments lie outside the usual sphere of the Emerg physician’s activities.
However your next patient is a mildly cognitively impaired older person with six medications who lives alone — and now has a pelvic fracture. It’s Friday afternoon and your hospital has no available beds for admission.
- What are you going to do?
- What resources do you have in your Emergency Department to assess this patient?
- What are your options for discharge planning?
Remember that just as it takes a village to raise a child, it takes a team to care for an older ED patient.
Some Emergency Departments have developed an interdisciplinary team to support the assessment of this patient:
- a geriatric nurse,
- a specialized social worker,
- a direct link to home care,
- a means of accessing physiotherapy, a pharmacist, and occupational therapy,
- a protocol to hold the patient in the ED overnight to develop a more comprehensive plan for discharge. For an example of a Pre-Printed Order Record, click here.
It all takes time and people – but ultimately provides better care to the patient and better use of resources.