1. Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review
- Author
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Scott M. Dresden, Zachary Taylor, Peter Serina, Maura Kennedy, Annie B. Wescott, Teresita Hogan, Manish N. Shah, Ula Hwang, Neelum T. Aggarawal, Heather Allore, Amy Aloysi, Michael Belleville, Fernanda M. Bellolio, Marian (Emmy) Betz, Kevin Biese, Cynthia Brandt, Stacey Bruursema, Ryan Carnahan, Christopher Carpenter, David Carr, Jennie Chin-Hansen, Morgan Daven, Nida Degesys, Jeffrey Dussetschleger, Michael Ellenbogen, Jason Falvey, Beverley Foster, Cameron Gettel, Angela Gifford, Andrea Gilmore-Bykovskyi, Elizabeth Goldberg, Jin Han, James Hardy, Susan N. Hastings, Jon M. Hirshon, Ly Hoang, William Hung, Eric Isaacs, Naveena Jaspal, Deb Jobe, Jerry Johnson, Kathleen (Kathy) Kelly, Amy Kind, Jesseca Leggett, Michael Malone, Michelle Moccia, Monica Moreno, Nancy Morrow-Howell, Armin Nowroozpoor, Ugochi Ohuabunwa, Brenda Oiyemhonian, William Perry, Beth Prusaczyk, Jason Resendez, Kristin Rising, Mary Sano, Bob Savage, Manish Shah, Joe Suyama, Jeremy Swartzberg, Vaishal Tolia, Allan Vann, Teresa Webb, and Sandra Weintraub
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Emergency Medical Services ,Health Policy ,Outcome Assessment, Health Care ,Humans ,Dementia ,General Medicine ,Geriatrics and Gerontology ,Emergency Service, Hospital ,Geriatric Assessment ,General Nursing ,Aged - Abstract
To summarize research on optimal emergency department (ED) care practices for persons living with dementia (PLWDs) and develop research priorities.Systematic scoping review.PLWDs in the ED.The following Patient-Intervention-Comparison-Outcome (PICO) questions were developed: PICO 1, What components of emergency department care improve patient-centered outcomes for persons with dementia? PICO 2, How do emergency care needs for persons with dementia differ from other patients in the emergency department? A scoping review was conducted following PRISMA-ScR guidelines and presented to the Geriatric Emergency care Applied Research 2.0 Advancing Dementia Care network to inform research priorities.From the 6348 publications identified, 23 were abstracted for PICO 1 and 26 were abstracted for PICO 2. Emergency care considerations for PLWDs included functional dependence, behavioral and psychological symptoms of dementia, and identification of and management of pain. Concerns regarding ED care processes, the ED environment, and meeting a PWLD's basic needs were described. A comprehensive geriatric assessment and dedicated ED unit, a home hospital program, and a low-stimulation bed shade and contact-free monitor all showed improvement in patient-centered or health care use outcomes. However, all were single-site studies evaluating different outcomes. These results informed the following research priorities: (1) training and dementia care competencies; (2) patient-centric and care partner-centric evaluation interventions; (3) the impact of community- and identity-based factors on ED care for PLWDs; (4) economic or other implementation science measures to address viability; and (5) environmental, operational, personnel, system, or policy changes to improve ED care for PLWDs.A wide range of components of both ED care practices and ED care needs for PLWDs have been studied. Although many interventions show positive results, the lack of depth and reproducible results prevent specific recommendations on best practices in ED care for PLWDs.
- Published
- 2022