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Class Progress
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Chapter Listing

Emergency Department Management of Elderly Patients - DEMO


Over the next decade, the rise of people ages 65 and older in the United States will more than double, and those ages 85 and older will more than triple. Approximately 80% of older adults have at least one chronic disease (such as heart disease and diabetes). Up to 65% of older individuals have two or more chronic diseases and 43% of persons have three or more long-term health conditions.

Older individuals comprise an increasing share of emergency department (ED) patients, in part due to a higher prevalence of chronic diseases, and their susceptibility to frequent exacerbations of these conditions. Chronic disease and illness in elderly patients are typically more complex than in younger individuals for a variety of reasons; the presentation of medical problems is often:

  • Atypical (such as pneumonia or UTI presenting as confusion, rather than with a cough or painful urination)
  • Vague, intermittent and non-specific symptoms, which are often difficult to differentiate from specific and serious acute conditions
  • Likely to present with a greater level of acuity

Moreover, disease presentations are complicated by the presence of:

  • Multiple comorbidities that make diagnosis more difficult
  • Polypharmacy (taking five or more medications can result in drug-drug side effects, impaired cognition, falls, etc.)
  • Functional and mobility impairments
  • Communication/cognitive problems
  • Social/economic factors (caregiver support, transportation, finances, etc.)
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