Aging in the ER: Geriatric Emergency Medicine

As global life expectancy rises, healthcare must adapt - and this is especially true in emergency medicine. How can you best recognize and meet the needs of your older patients?

Aging in the ER: Geriatric Emergency Medicine

This topic never gets old! Whether you realize it or not, geriatrics is probably a large part of your practice especially when it comes to high-complexity, high-acuity Emergency Medicine. Dr. Lauren Southerland will teach us what we can do to better care for older adults. We’ll also discuss how to get involved at the national level and how to pursue a career in geriatric EM if you want to go a step further. 

Key Resources

• Age-friendly health systems and the 4M model 
• National Association of Area Agencies on Aging: https://www.n4a.org/
• Geriatric Emergency Department Accreditation Program
• ACEP Geriatric Emergency Medicine Section: 
• SAEM Academy of Geriatric Emergency Medicine  
• AAEM Geriatrics Committee

Key Points

1. Older adults are a significant portion of our ED patient population and are often our high-acuity, high-complexity patients. 
2. Older adults have unique needs and it's best to take a holistic approach, including understanding their social support. Most of all, they are deserving of dignity. 
3. When caring for older adults, incorporate the 4M model for age-friendly health systems: 
• Medications: What medications are they on? Are they on any medications that may be worsening their clinical condition or are unnecessary? Are they taking the medications they need? 
• Mentation: is depression, dementia, or delirium affecting your patient? 
• Mobility: is your patient at their mobility baseline? Are they at increased fall risk? Would they benefit from physical therapy or assistive devices? 
• What Matters: what is most important in your patient's life? What are their preferences and goals of care? This is not limited to their code status or end-of-life care. 
4. Find out what community partners are available. This includes EMS, social work, case management, home health agencies, meal assistance programs, physical and occupational therapy, and the area agency on aging. 
5. If you're interested in geriatric medicine, get involved at the national level. Consider choosing a residency where you will find mentors in geriatrics or even pursuing a fellowship. 

References

• Bambach K, Southerland L. Applying Geriatric Principles to Transitions of Care in the Emergency Department. Emerg Med Clin North Am. 2021. doi:10.1016/j.emc.2021.01.006
• Song "Me and the Man in the Moon" by The Ambassadors, written by James Monaco and Edgar Leslie