• Am J Emerg Med · Jun 2021

    Mind the caretaker: ED referrals of community-dwelling older adult patients by their primary caregivers are accurate.

    • Ami Schattner, Amin Sabbah, and Ina Dubin.
    • Department of Medicine, Laniado Hospital, Sanz Medical Center, Netanya, Israel; The Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel. Electronic address: amischatt@gmail.com.
    • Am J Emerg Med. 2021 Jun 1; 44: 92-94.

    BackgroundED referral of older adults on the initiative of their family or paid live-in caregiver is common but not previously studied.MethodsED-presenting community-dwelling patients ≥65 years were studied, emphasizing the referring agent, and correct (admitted or discharged +changed diagnosis/treatment) vs. incorrect referral (discharged, no change made).ResultsOf 448 consecutive patients (median age 83 years), 231 were referred by their primary physician (PCP) (73% admitted, 17% discharged +change). 117 ED referrals were initiated by their family (78% admitted, 6% discharged +change), and 100 by their paid caregiver (66% admitted, 21% discharged +change). Differences were non-significant, as was the distribution of main diagnoses.ConclusionsED referral of older adults from the community by laymen who know the patient well (family or caregiver) is non-inferior to a referral by their PCP. ED physicians should regard non-physician ED presentations as seriously as a referral by a physician, pending confirmation in future studies.Copyright © 2021 Elsevier Inc. All rights reserved.

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