2022 Summer GAPNA Newsletter Volume 41 Number 2

Geriatric Emergency Care for Older Veterans

By Katherine Voss

Compared to other emergency department visits, Veterans Affairs (VA) Emergency Department visits see double the rate of adults over the age of 65, due to over half of the nation’s Veterans being in this age cohort (Office of Public and Intergovernmental Affairs, 2021).

Studies show increased risk for adverse effects after discharge from VA Emergency Departments, including repeat VA Emergency Department visits, hospitalization, and death (Hastings et al., 2007). Geriatric Veterans have higher multi-morbid health conditions and complex needs as they age.

Recent studies show enhanced screening for cognitive impairment, delirium, fall risk, functional decline, and caregiver burden within the emergency department can reduce the frequency of adverse effects by more quickly facilitating follow up including social and professional care (Huded et al., 2022; Hwang et al., 2021).

As a result, the number of VA Emergency Departments to adopt these practices and become accredited by the American College of Emergency Physicians as a Geriatric Emergency Department grew nationwide over the last several years and is expected to continue growing to provide better quality care for geriatric Veterans (Office of Public and Intergovernmental Affairs, 2021).

Katherine Voss, AGNP-C
katherine.lange.voss@gmail.com

References

Hastings, S.N., Schmader, K.E., Sloane, R.J., Weinberger, M., Goldberg, K.C., & Oddone, E.Z. (2007). Adverse health outcomes after discharge from the emergency department – Incidence and risk factors in a veteran population. Journal of General Internal Medicine, 22(11), 1527-1531. https://doi.org/10.1007/s11606-007-0343-9

Huded, J.M., Lee, A., Song, S., McQuown, C.M., Wilson, B.M., Smith, T.I., & Bonomo, R.A. (2022). Association of a geriatric emergency department program with healthcare outcomes among veterans. Journal of the American Geriatrics Society, 70(2), 601-608. https://doi.org/10.1111/jgs.17572

Hwang, U., Dresden, S.M., Vargas-Torres, C., Kang, R., Garrido, M.M., Loo, G., … Zhu, C.W. (2021). Association of a geriatric emergency department innovation program with cost outcomes among Medicare beneficiaries. JAMA Network Open, 4(3), e2037334. https://doi.org/10.1001/jamanetworkopen.2020.37334

Office of Public and Intergovernmental Affairs. (2021). VA enhances geriatric emergency care for older veterans. https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5712