Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Mar 2009
The diagnosis of delirium among elderly patients presenting to the emergency department of an acute hospital.
Delirium is prevalent among elderly people presenting to an emergency department (ED). However, despite the fact that delirium is associated with longer hospital stays, an increased rate of institutionalization and higher mortality (especially in the case of undiagnosed delirium), this condition often goes undiagnosed by ED doctors. We examined the rate of mental status assessment and the prevalence of delirium in the ED among patients older than 65 years in a large teaching hospital in Southern Israel via a retrospective chart review. ⋯ Furthermore, only 12.5% of people received either an adequate or even a partially adequate mental status assessment by the ED doctors. We attribute these negative findings not to a low incidence of delirium but probably to a combination of a heavy workload along with a lack of adequate training of ED physicians. We suggest that part of the solution involves providing appropriate education to ED physicians as well as adding a geriatric consultant to the ED roster.
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Arch Gerontol Geriatr · Mar 2009
Emergency department (ED) utilization of oldest old men in a veterans care home in Taiwan.
ED is a common channel for older people to seek for medical services. However, unlike most care homes in the world, veterans care home in Taiwan has a constantly operating outpatient and inpatient services. Therefore, utilization of ED services among veterans care home may be different from most care home residents. ⋯ Nearly a half of Banciao Veterans Home residents had visited ED for at least once in 2006 and the medical expenditure was four times higher than other ED visitors. In average, 52.3% of ED visitors would be hospitalized and the most common diagnosis was infectious conditions. Onsite primary care geriatricians may play an important role in such settings.