Caring for older patients in the emergency department: Health professionals' perspectives from Australia - The Safe Elderly Emergency Discharge project

Objective: To explore health professionals' perspectives about caring for community-dwelling older patients in the ED. Methods: This exploratory qualitative study was undertaken with emergency nursing, medical and allied health staff from the ED of a large metropolitan public hospital in Melbourne. Nine focus groups (n =54) and seven interviews were conducted between 2013 and 2014. Data were thematically analysed. Results: Health professionals described tailoring their approach when caring for older patients, including adopting a specific communication approach (i.e. increased voice volume, slower rate of speech). Caring for older patients was perceived as challenging given the need to balance the expectations of family members to deal with associated complex needs and limited time for transitional care planning in the ED. The environment and equipment were perceived as unsuitable, alongside a lack of geriatric-specific knowledge; contributing to what health professionals described as a poor fit between the ED system and older patients' needs. Conclusion: The growing number of older patients presents numerous challenges for emergency health professionals and necessitates a tailored approach to care. Understanding health professionals' perspectives about caring for older patients can inform strategies that may improve the quality of care. Creating older person-friendly areas, improving transitional care and providing staff with specific education would foster an environment that promotes person-centred care, safety, independence and functional wellbeing.