Manuscript Topics

The number of older inpatients has been steadily increasing worldwide. Changing global demography is resulting in increasing numbers of older people presenting to emergency departments (EDs) and also being more likely to be admitted to hospital; in 2015 in Europe, the percentage of older patients admitted from EDs was 50% compared to 16% for those under 65. The percentage of older patients is projected to increase over the next decade with more than 25% of ED visits by 2030. Older patients are known to experience longer waits for care and suffer poorer health outcomes after ED attendance, with higher mortality rates, greater dependence in activities and higher rates of admission to nursing homes. Whereas the younger patient typically presents to EMS and EDs with a symptom-based chief complaint, geriatric adults more commonly report atypical or non-specific symptoms that prompted the patient to seek medical care. Although these symptoms can be the manifestation of an acute and reversible life-threatening illness, more often, the symptoms are a result of a complex mix of chronic disease processes. Emergency medical services traditionally have not had specific training on how to recognize or manage geriatric-specific pathologies, yet there is recognition at the national service level for the need to improve knowledge and integrate care services with the ultimate goal of reducing unplanned admissions to hospital or attendances to emergency departments.

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