Date of Award
MSc by research (Master of Science by research)
Dr. Frances Horgan
Emergency Department, Elderly Population, Fallers, Healthcare Utilisation, Frailty, Ireland
Introduction: Falls are the commonest reason why an older person presents to the Emergency Department (ED) in Ireland and can account for 20-40% of attendances (Aminzadeh and Dalziel 2002). As the population ages it is anticipated that the incidence of falls will increase (Barrett et al, 2011). A profile of the elderly faller could identify the healthcare services in which this population relies on.
Aims and Objectives: The aims of this study were to profile a sample of elderly fallers attending the ED of an Irish hospital. The objectives of the study were to examine prevalence and circumstances of these falls, to describe the socio-demographic and health profile of these patients and to document the healthcare utilisation among the sample.
Methods: This was a cross-sectional, observational study in which 93 participants were recruited at discharge from an Irish ED. A demographic profile along with healthcare utilisation was determined from the ED chart and Patient Administration System (PAS). Participants completed a questionnaire to determine the presence of frailty, a falls profile, and level of social support available.
Results: The mean age of participants was 76.5 years of age. Recurrent falls were noted in 46% of the sample. Polypharmacy was identified in 43 (55.8%) participants. Twenty (21.5%) participants belonged to a vulnerable social network type. Just over half (52.7%) of participants were identified at risk of decline. Seventeen (18.3%) of the 93 participants had a previous visit to the ED in the previous six months. High healthcare follow up was noted with 89.2% of participants referred to either community services or out-patient appointments.
Conclusions and implications: This study described an elderly population at risk of functional decline with high healthcare needs. The findings of this study could form the basis of the development of a standardised frailty screening and intervention programme for elderly fallers attending the ED and highlights missed opportunities for frailty management.
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Lang SL. A profile of elderly fallers attending the emergency department and their patterns of healthcare utilisation [MSc Thesis]. Dublin: Royal College of Surgeons in Ireland; 2016.