Concerns of older patients and their caregivers in the emergency department

Noortje Zelis*, Sarah E. Huisman, Arisja N. Mauritz, Jacqueline Buijs, Peter W. de Leeuw, Patricia M. Stassen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background

Older emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking.

Methods

This study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients (>= 65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes.

Results

Most of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p7 days, loss of independent living and unplanned readmission within 30 days) (OR 2.32; 95%CI: 1.12-4.82). In addition, unspecified concerns were associated with mortality (OR 1.88; 95%CI: 1.09-3.22).

Conclusion

The majority of older patients and especially their caregivers are concerned about their medical condition or need for medical care when they visit the ED. These concerns are associated with adverse outcomes and most likely reflect their needs regarding medical care. More attention should be paid to these concerns because they may offer opportunities to reduce anxiety and provide care that is adjusted to their needs.

Original languageEnglish
Article number0235708
Number of pages10
JournalPLOS ONE
Volume15
Issue number7
DOIs
Publication statusPublished - 9 Jul 2020

Keywords

  • ADULTS
  • CARE
  • PERCEPTIONS
  • OUTCOMES

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