Palliative care specialists who followed hundreds of residents through the stages of emergency department transfer and care have pinpointed the symptoms and functional factors that they say predict the likelihood of optimal outcomes.
The researchers followed health outcomes of 751 residents of French nursing homes who were transferred to emergency departments over four non-consecutive weeks (one week per season) in 2016. They measured patterns of symptoms, including pain, dyspnea (difficulty breathing), fever, agitation, confusion and fatigue at four points in the process: before the emergency department transfer, during transfer, in the emergency department, and after discharge.
Residents who had pain, fever or dyspnea were more likely to recover from their symptoms than those with confusion, agitation and fatigue, reported Vincent Guion, a palliative care specialist and Ph.D. candidate from Gérontopôle of the Toulouse University Hospital Center.
The results show that a resident’s resilience in the face of an emergency department transfer may be predicted by comorbidities and functional abilities, and challenged by acute conditions associated with various levels of stress, the authors contend.
This potential for resilience, or lack thereof, is key to determining the appropriateness of an emergency department transfer and should facilitate advance care planning in resident hospitalizations, the authors concluded.
The study was published in the Journal of Nutrition, Health and Aging.