Care for older adults in Emergency Departments (EDs) has historically been focused on acute
medical conditions with little emphasis on geriatric-specific issues. In 2010 emergency
departments (EDs) throughout the nation saw almost 130 million patients 15% of whom were 65 or
older. The number of older adults who visit an ED has doubled in the last decade and continues
to grow rapidly. Older adults receiving care in an ED are highly likely to be admitted to the
hospital much more so than their younger counterparts. Preventing a hospital admission saves
older adults from frequently encountered adverse events including hospital-acquired delirium
functional status impairment cognitive loss and nursing home admission. It is unknown how
many older adults are hospitalized for reasons other than acute medical illness such as
functional decline polypharmacy progressive dementia caregiver stress or unstable living
situation. These non-emergent conditions are rarely addressed during a typical ED visit due to
lack of resources significant patient volumes and the need for rapid turnover of care spaces.
The predominant management strategy of emergency physicians to handle these important but not
imminently life-threatening geriatric issues is to recommend hospital admission. Northwestern
has pioneered the Geriatric Emergency Department through the creation of the Geriatric
Emergency Department Innovation model (GEDI) with goals to prevent admissions for older adults
by assessing and meeting their geriatric-specific non-acute care needs in the ED. The GEDI
model at Northwestern centers on a multi-disciplinary curriculum composed of clinical didactic
and practical arms developed by emergency medicine and geriatrics educational experts. In this
title we will present case studies of older adults seen in the Emergency Department through
the GEDI model and discuss means of identifying screening for diagnosing and treating
geriatric syndromes seen in the emergent care of the older adult patient. In addition there
will be a set of concise take-home points for each case study that will be easy to commit to
memory and implement in clinical care of older adults. As the number of seniors seeking
emergent care will continue to increase the ED setting must become responsive to
geriatric-specific needs. This book will provide a variety of models detailing how to offer
comprehensive state-of-the-art optimal care for managing the full range of geriatric
syndromes that regularly present in the emergent care setting.
