Hospitals focus on seniors to prevent readmissions, adverse events

Seniors over-estimate their ability to perform tasks, such as getting in and out of bed, after discharge from the emergency department, putting them at greater risks for falls, complications and readmissions, according to a new study in the Annals of Emergency Medicine.

Seniors are already at high risk for complications, falls and readmissions--and hospitals are taking note. Some create special emergency centers to cater to the growing senior population. For example, Ohio State University's Wexner Medical Center has staffed its new elder emergency care facility with nurses, social workers, case managers, therapists and geriatricians.

But direct observation before discharge is a critical step that emergency clinicians often miss, according to the study. Of 272 patients, 76 percent said they could perform simple mobility tasks either without assistance or with a cane or walker, but discrepancies between self-reported ability and actual performance were common. Even among those who said they could perform the task with assistance, nearly a quarter were unable to do so.

Of those who said they could perform the task without assistance, 12 percent required some assistance or couldn't complete the task. Of those who said they could perform the task with a cane or walker, 48 percent required additional assistance or couldn't perform the task.

"For older adults being considered for discharge who report a need for assistance with mobility, direct observation of the patient's mobility by a member of the emergency care team should be considered," the authors conclude. "We suggest that this assessment be made early during the ED visit because disposition momentum and the challenge of arranging additional outpatient care may make it difficult for emergency providers to change disposition late during the ED visit."

To learn more:
- here's the study

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