EDs fail to recognize elder cognitive impairment

Older patients with cognitive impairment, such as dementia and delirium, pay a large number of visits to emergency departments (ED), but EDs may be ill equipped to identify their impairment, according to a study in the Journal of Advanced Nursing (JAN).

Researchers at the University of Alberta reviewed literature from 1994 to 2009 of patients over the age of 65 in the U.S., Canada, Australia, Italy, New Zealand, and Israel. They found that older adults are more likely than other age groups to request an ambulance and receive acute interventions on arrival.

"Older patients with cognitive impairment are unable to make decisions for themselves or function independently when they visit an emergency department" said lead author Dr. Belinda Parke, assistant professor in the University's Faculty of Nursing, in a press release. "They tend to be more helpless, demand special attention and fail to co-operate, posing many challenges for healthcare staff during admission, assessment and treatment."

Researchers found that the most common cognitive impairment was delirium, which is difficult to recognize and poorly recognized by ED physicians, note researchers. Although there are assessment tools available to identify cognitive impairment, they are not ideal for busy EDs, according to the press release.

Healthcare professionals must understand cognitive impairment conditions to effectively intervene, as well as use an appropriate screening tool, when needed, according to researchers.

To learn more:
- read the JAN study abstract
 - check out the press release

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