%0 Journal Article
%T The Psychogeriatric Patient in the Emergency Room: Focus on Management and Disposition
%A Sherry Tang
%A Priyanka Patel
%A Jagdish Khubchandani
%A George T. Grossberg
%J ISRN Psychiatry
%D 2014
%R 10.1155/2014/413572
%X Background. The growing geriatric population in the United States (US) has prompted better understanding of treatment of the elderly in the hospital and emergency room (ER) settings. This study examines factors influencing the disposition of psychogeriatric patients after their initial presentation in the ER. Methods. Data was collected on patients 65 years of age or older arriving at the ER of a large urban hospital in the USA (January 2009¨CDecember 2010). Results. Of the total subjects ( ) included in the study, majority were females (66.3%) with an average age of 75.5 years. The chief complaint for psychogeriatric patients coming to the ER was delirium (61.6%). Caucasians were significantly more likely than African-American patients to get a psychiatric consult (33% versus 9%). Patients with delirium were less likely than patients with other psychiatric complaints to get a psychiatric consult in the ER (1.2% versus 47.2%) and less likely to be referred to a psychiatric inpatient unit compared to patients with other psychiatric complaints (2.4% versus 16.7%). Conclusion. Even though delirium is the most common reason for ER visits among psychogeriatric patients, very few delirium patients got a psychiatric consultation in the ER. A well-equipped geriatric psychiatry unit can manage delirium and associated causes. 1. Introduction According to the recent United States (US) census bureau report, the older population (65+ years of age) is projected to increase to 88.5 million by 2050, which is more than double the population of elderly people (40.2 million) in 2010 [1]. Due to the surge in the aging population, the US health care system will face increasing challenges in caring for older adults in the near future. Emergency rooms (ER) have been increasingly visited by older adults who present with complex medical conditions and who are more likely to have longer stays, requiring extensive testing, and treatment regimens [2]. The geriatric patients are a unique group and specific considerations should be included in the interventions for these patients. More specifically, psychogeriatric patients may have a variety of clinical presentations, including delirium, behavioral changes, mood disorders, and others. Impaired mental status occurs in approximately one quarter of all older patients presenting to the ER [3]. Delirium is a serious disturbance in a person¡¯s mental abilities that results in a decreased awareness of one¡¯s environment and confused thinking. The onset of delirium is usually sudden, often within hours or a few days. While several studies
%U http://www.hindawi.com/journals/isrn.psychiatry/2014/413572/