Patterns of care partner communication for persons living with dementia in the emergency department

Authors

Adrian D. Haimovich, Department of Emergency Medicine, Beth Israel Deaconess Medical CenterFollow
Aidan Gilson, Department of Emergency Medicine, Yale School of MedicineFollow
Evangeline Gao, Department of Emergency Medicine, Yale School of MedicineFollow
Ling Chi, Department of Emergency Medicine, Yale School of Medicine, New Haven, CTFollow
Cameron J. Gettel, Department of Emergency Medicine, Yale School of Medicine, New Haven, CTFollow
Mara Schonberg, Department of Emergency Medicine, Beth Israel Deaconess Medical CenterFollow
Ula Hwang, Department of Emergency Medicine, Yale School of Medicine, New Haven, CTFollow
Richard A. Taylor, Yale School of MedicineFollow

Author ORCID Identifier

https://orcid.org/0000-0002-9082-6644

Abstract

Abstract

Background:

Nearly half of all persons living with dementia (PLwD) will visit the emergency department (ED) in any given year and ED visits by PLwD are associated with short-term adverse outcomes. Care partner engagement is critical in the care of PLwD, but little is known about their patterns of communication with ED clinicians.

Methods:

We performed a retrospective electronic health record (EHR) review of a random sampling of patients ≥ 65 years with a historical diagnosis code of dementia who visited an ED within a large

regional health network between 1/2014 and 1/2022. ED notes within the EHRs were coded for documentation of care partner communication and presence of a care partner in the ED. Logistic regression was used to identify patient characteristics associated with the composite outcome of either care partner communication or care partner presence in the ED.

Results:

A total of 460 patients were included. The median age was 83.0 years, 59.3% were female, 11.3% were Black, and 7.6% Hispanic. A care partner was documented in the ED for 22.4% of the visits and care partner communication documented for 43.9% of visits. 54.8% of patients had no documentation of care partner communication nor evidence of a care partner at the bedside. In multivariate logistic regression, increasing age (OR, (95% CI): 1.06 (1.04-1.09)), altered mental status (OR: 2.26 (1.01-5.05)), and weakness (OR: 3.38 (1.49-7.65)) significantly increased the probability of having care partner communication documented or a care partner at the bedside.

Conclusions:

More than half of PLwD in our sample did not have clinician documentation of communication with a care partner or a care partner in the ED. Further studies are needed to use these insights to improve communication with care partners of PLwD in the ED.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Recommended Citation

Haimovich, Adrian D.; Gilson, Aidan; Gao, Evangeline; Chi, Ling; Gettel, Cameron J.; Schonberg, Mara; Hwang, Ula; and Taylor, Richard A. (2023) "Patterns of care partner communication for persons living with dementia in the emergency department," Journal of Geriatric Emergency Medicine: Vol. 4: Iss. 1, Article 5.
DOI: https://doi.org/10.17294/2694-4715.1043
Available at: https://institutionalrepository.aah.org/jgem/vol4/iss1/5