“The success of the Geriatric ED programs rests largely on the education of a multi-disciplinary staff directed toward the needs of the geriatric population.”
What Should it Include?
An education program should include the following subjects:
- Atypical presentations of disease
- Trauma and falls
- Cognitive evaluation and delirium
- Medication management
- Pain management and palliative care
- Functional assessment and discharge plan
- Others: abdominal pain in older adults, general weakness evaluation, elder abuse and neglect, ethical and cultural issues
Who Should it Target?
Health professional including the following:
- Medical students
- Residents (Family medicine, emergency medicine, internal medicine and surgery)
- Emergency Physicians
- Nurses
- Emergency Medical Services personnel (EMS)
How?
A mix of didactic lectures, case conference, simulations, journal clubs and hands-on education.
Web-based materials. There is an amazing website that correspond to the educational program needs and suits various level of healthcare providers: www.geri-em.com. It is free and provides training credentials (CME credits).
Periodic re-education and updates on changes of procedure or community programs.
Why?
Objectives of a specific geriatric training are the following:
- To increase awareness of the various medical issues specific to this population;
- To better understand, assess and address the needs of the elderly population;
- To provide familiarity with use of quick bedside assessment tools;
- To generate a culture of change and adaptability about this major demographic shift.
Ideas for Increasing Engagement
Here is a good trick to engage your ED team to pursue this training: show them that there is a significant gap in knowledge about geriatric medicine by using a survey/questionnaire!
Do not forget to train and monitor new staff on all senior-friendly initiatives before they starting to working in your Senior-Friendly ED.
References and Resources
- The Geri-ED Guidelines
- www.Geri-EM.com continuing education resource
- Seymour B, Chijioke R, Patel A, et al. Portal of Online Geriatric Education (POGOe): High fidelity simulations to teach key concepts in emergency department care of the elderly Portal of Online Geriatric Education (POGOe) web site. Available at: http://www.pogoe.org/productid/20973. Accessed September 25, 2013.
- Brymer C, Cavanagh P, Denomy E, et al. The effect of a geriatric education program on emergency nurses. J Emerg Nurs. 2001;27: 27-32.
- Biese K, Roberts E, LaMantia MA, et al. Effect of a geriatric curriculum on emergency medicine resident attitudes, knowledge, and decision-making. Acad Emerg Med. 2011;18: S92-S96.
- Snider T, Melady D, Costa AP. A national survey of Canadian emergency medicine residents’ comfort with geriatric emergency medicine. Cjem. 2016 Apr 18:1-9. PubMed PMID: 27086864.
- Prendergast HM, Jurivich D, Edison M, et al. Preparing the front line for the increase in the aging population: geriatric curriculum development for an emergency medicine residency program. J Emerg Med. 2010;38: 386-392.
- Geriatric Videos American College of Emergency Physicians web site. Available at: http://www.acep.org/Clinical—Practice-Management/Geriatric-Videos/. Accessed March 31, 2017.
- McNamara RM, Rousseau E, Sanders AB. Geriatric Emergency Medicine: A Survey of Practicing Emergency Physicians. Ann Emerg Med. 1992;21: 796-801.
- Hogan TM, Losman ED, Carpenter CR, et al. Development of geriatric competencies for emergency medicine residents using an expert consensus process. Acad Emerg Med 2010;17: 316-324.
- Leipzig RM, Granville L, Simpson D, et al. Keeping granny safe on July 1: a consensus on minimum geriatrics competencies for graduating medical students. Acad Med. 2009;84: 604-610.
- Jones J, Dougherty J, Cannon L, et al. A geriatrics curriculum for emergency medicine training programs. Ann Emerg Med. 1986;15: 1275-1281.
- Wadman MC, Lyons WL, Hoffman LH, et al. Assessment of a chief complaint-based curriculum for resident education in geriatric emergency medicine. West J Emerg Med. 2011;12: 484-488
- Meldon SW, Ma OJ, Woolard R. Geriatric Emergency Medicine, 1 ed., Dallas, McGraw-Hill Companies, Inc.; 2004.
