Abstract
Introduction
Seniors are often accompanied by a family member to the emergency department. Families
advocate for their needs and contribute to the continuity of care. However, they often
feel excluded from care. To improve the quality and safety of care for seniors, it
is necessary to consider the experience of families in the emergency department. The
aim was to identify and synthesize the available scientific literature dealing with
the experience of families accompanying a senior to the emergency department. To identify
and synthesize the available scientific literature dealing with the experience of
families accompanying a senior to the emergency department.
Methods
A scoping review was conducted using the Arksey and O’Malley framework. Six databases
were targeted. A description of the identified scientific literature and an inductive
content analysis were performed.
Results
Of the 3082 articles retrieved, 19 met the inclusion criteria. Most articles (89%)
were published since 2010, were from nursing (63%), and used a qualitative research
design (79%). The content analysis identified 4 main categories related to the experience
of families accompanying a senior to the emergency department: (1) process leading
to the emergency department, families feel uncertainty and ambiguity with the decision
to go to the emergency department; (2) staying in the emergency department, families’
experiences are influenced by the triage, the ED environment, and the interactions
with ED personnel; (3) discharge from the emergency department, families consider
that they should be part of the discharge planning; and (4) recommendations and possible
solutions, there is a paucity of recommendations specifically focused on families.
Discussion
The experience of families of seniors in the emergency department is multifactorial
and part of a trajectory of care and health services.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency NursingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Older adults and population aging: statistics. Statistics Canada. Updated November 18, 2022.(Statistics Canada)https://www.statcan.gc.ca/en/subjects-start/older_adults_and_population_agingDate accessed: November 29, 2022
- Ageing and health. Word Health Organization.(Published October 1, 2022)https://www.who.int/news-room/fact-sheets/detail/ageing-and-healthDate accessed: November 18, 2022
- Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change.Aust Heal Rev. 2017; 41: 246-253https://doi.org/10.1071/AH15165
- Quality indicators in the care of older persons in the emergency department: a systematic review of the literature.Australas J Ageing. 2017; 36: 286-298https://doi.org/10.1111/ajag.12451
- Emergency department utilization by older adults: a descriptive study.Can Geriatr J. 2014; 17: 118-125https://doi.org/10.5770/cgj.17.108
- Increasing rates of emergency department visits for elderly patients in theUnited States, 1993 to 2003.Ann Emerg Med. 2008; 51: 769-774https://doi.org/10.1016/j.annemergmed.2007.09.011
- Negative health outcomes and adverse events in older people attending emergency departments: a systematic review.Australas Emerg Nurs J. 2011; 14: 141-162https://doi.org/10.1016/j.aenj.2011.04.001
- The geriatric emergency department intervention model of care: a pragmatic trial.BMC Geriatr. 2018; 18: 297https://doi.org/10.1186/s12877-018-0992-z
- Older people in the emergency department: a literature review.Int J Older People Nurs. 2015; 10: 284-305https://doi.org/10.1111/opn.12090
- A systematic review of outcomes following emergency transfer to hospital for residents of aged care facilities.Age Ageing. 2014; 43: 759-766https://doi.org/10.1093/ageing/afu117
- Transfer from residential aged care to emergency departments: an analysis of patient outcomes.Int Med J. 2012; 42: 75-82https://doi.org/10.1111/j.1445-5994.2010.02224.x
- Decision to transfer to an emergency department from residential aged care: a systematic review of qualitative research.Geriatr Gerontol Int. 2013; 13: 825-833https://doi.org/10.1111/ggi.12053
- What older people want from emergency care: a systematic review.Emerg Med J. 2019; 36: 754-761https://doi.org/10.1136/emermed-2019-208589
- Nurses’ experiences and expectations of family and carers of older patients in the emergency department.Int Emerg Nurs. 2014; 22: 31-36https://doi.org/10.1016/j.ienj.2013.03.007
- Caring for older people with dementia in the emergency department.Br J Nurs. 2020; 29: 692-699https://doi.org/10.12968/bjon.2020.29.12.692
- Experiences of family members of elderly patients in the emergency department: a qualitative study.Int Emerg Nurs. 2012; 20: 193-200https://doi.org/10.1016/j.ienj.2012.08.003
- Aged care residents in the emergency department: the experiences of relatives.J Clin Nurs. 2015; 24: 3647-3653https://doi.org/10.1111/jocn.12954
- Scoping studies: towards a methodological framework.Int J Soc Res Methodol. 2005; 8: 19-32https://doi.org/10.1080/1364557032000119616
- The qualitative content analysis process.J Adv Nurs. 2007; 62: 107-115https://doi.org/10.1111/j.1365-2648.2007.04569.x
- “They never talked to me about…”: perspectives on aged care resident transfer to emergency departments.Australas J Ageing. 2015; 34: 95-102https://doi.org/10.1111/ajag.12125
- BUILDCARE study. Patterns of emergency department attendance among older people in the last three months of life and factors associated with frequent attendance: a mortality follow-back survey.Age Ageing. 2019; 48: 680-687https://doi.org/10.1093/ageing/afz043
- Older peoples’ experience of accessing emergency care.Australas Emerg Nurs J. 2010; 13: 61-69https://doi.org/10.1016/j.aenj.2010.05.001
- At risk for emotional harm in the emergency department: older adult patients’ and caregivers’ experiences, strategies, and recommendations.Gerontol Geriatr Med. 2018; 42333721418801373https://doi.org/10.1177/2333721418801373
- Factors influencing emergency care by persons with dementia: stakeholder perceptions and unmet needs.J Am Geriatr Soc. 2019; 67: 711-718https://doi.org/10.1111/jgs.15737
- Older patients awaiting emergency department treatment.Scand J Caring Sci. 2004; 18: 169-176https://doi.org/10.1111/j.1471-6712.2004.00266.x
- Older patients’ understanding of medical information in the emergency department.Health Commun. 1997; 9: 237-251
- Factors for self-managing care following older adults’ discharge from the emergency department: a qualitative study.Can J Aging. 2019; 38: 76-89https://doi.org/10.1017/S071498081800034X
- Family involvement in emergency department discharge education for older people.J Clin Nurs. 2016; 25: 3333-3344https://doi.org/10.1111/jocn.13399
- Facilitators and barriers to safe emergency department transitions for community dwelling older people with dementia and their caregivers: a social ecological study.Int J Nurs Stud. 2013; 50: 1206-1218https://doi.org/10.1016/j.ijnurstu.2012.11.005
- Stakeholder perspectives on transitions of nursing home residents to hospital emergency departments and back in two Canadian provinces.J Aging Stud. 2012; 26: 419-427https://doi.org/10.1016/j.jaging.2012.06.001
- Expectations and experiences of older people and their carers in relation to emergency department arrival and care: a qualitative study in australia.Nurs Health Sci. 2015; 17: 476-482https://doi.org/10.1111/nhs.12220
Watkins S, Murphy F, Kennedy C, Dewar B, Graham M. Caring for an older person with dementia in the Emergency Department (ED): an Appreciative Inquiry exploring family member and ED nurse experiences. In: J Clin Nurs. the Emergency Department, ed. 2019;28(15-16):2801-2812. https://doi.org/10.1111/jocn.14854
- Assessing the impact of dementia inclusive environmental adjustment in the emergency department.Dementia (London). 2021; 20: 28-46https://doi.org/10.1177/1471301219862942
- Experiences of an emergency department visit among older adults and their families: qualitative findings from a mixed-methods study.J Patient Exp. 2020; 7: 346-356https://doi.org/10.1177/2374373519837238
- Older adult and family caregiver preferences for emergency department based-palliative care: an experience-based co-design study.Int J Nurs Stud Adv. 2021; 3100016https://doi.org/10.1016/j.ijnsa.2020.100016
- Family members’ perceptions of older person discharge from emergency departments.Int J Older People Nurs. 2021; 16: 1-10https://doi.org/10.1111/opn.12365
- Distress in caregivers accompanying patients to an emergency department: a scoping review.J Emerg Med. 2017; 53: 493-508https://doi.org/10.1016/j.jemermed.2017.03.028
- Family-centered primary care for older adults with cognitive impairment.Contemp Fam Ther. 2022; 44: 67-87https://doi.org/10.1007/s10591-021-09617-2
- Developing person-centred care competencies for the healthcare workforce to support family caregivers: caregiver centred care.Heal Soc Care Community. 2021; 29: 1327-1338https://doi.org/10.1111/hsc.13173
- Patient- and family-centered care. Institute for patients- and family centered care. Institute for Patients- and Family Centered Care.https://www.ipfcc.org/about/pfcc.htmlDate accessed: October 15, 2022
- Concepts in practice : geriatric emergency departments.Ann Emerg Med. 2020; 75: 162-170https://doi.org/10.1016/j.annemergmed.2019.08.430
- Geriatric emergency department guidelines. American College of Emergency Physicians, The American Geriatrics Society, Emergency Nurses Association, Society for Academic Emergency Medicine.(Published 2013. Accessed XXX.)
- Tracking the rise of geriatric emergency departments in the United States.J Appl Gerontol. 2020; 39: 871-879https://doi.org/10.1177/0733464818813030
- Balancing vision with pragmatism: the geriatric emergency department guidelines-realistic expectations from emergency medicine and geriatric medicine.J Am Geriatr Soc. 2022; 70: 1368-1373https://doi.org/10.1111/jgs.17745
- Experiencing transitions: an emerging middle-range theory.ANS Adv Nurs Sci. 2000; 23: 12-28https://doi.org/10.1097/00012272-200009000-00006
Biography
Gabriela Peguero-Rodriguez is a PhD candidate, School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; and an Assistant Professor, Nursing Department, Université du Québec en Outaouais, Gatineau, Québec, Canada. ORCID identifier: https://orcid.org/0000-0002-6491-0957.
Biography
Viola Polomeno is an Adjunct Professor, School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. ORCID identifier: https://orcid.org/0000-0002-9381-6791.
Biography
Chantal Backman is an Associate Professor, School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; an Affiliate Investigator, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; and an Affiliate Investigator, Bruyère Research Institute, Ottawa, Ontario, Canada. ORCID identifier: https://orcid.org/0000-0001-7431-8159.
Biography
Julie Chartrand is an Associate Professor, School of Nursing, Faculty of Health Sciences, University of Ottawa, Ontario, Ottawa, Ontario, Canada; and an Affiliate Investigator, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. ORCID identifier: https://orcid.org/0000-0001-9075-054X.
Biography
Michelle Lalonde is an Associate Professor, School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; and an Scientist, Institut du Savoir Montfort, Montfort Hospital, Ottawa, Ontario, Canada. ORCID identifier: https://orcid.org/0000-0002-8242-3159.
Article info
Publication history
Published online: May 13, 2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
