Language
English
Publication Date
8-1-2025
Journal
Internal and Emergency Medicine
DOI
10.1007/s11739-024-03797-z
PMID
39508982
PMCID
PMC12056158
PubMedCentral® Posted Date
8-9-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
ED crowding and boarding adversely impact older patients' care and outcomes. Little is known about how ED crowding impacts persons living with dementia, a vulnerable population. This study sought to explore ED experiences of caregivers of people with dementia during a period of ED crowding and boarding. We performed semi-structured interviews with caregivers of people with dementia with an ED visit during a period of ED crowding and boarding at two public hospitals experiencing a threefold increase in boarding from pre-pandemic levels. Participants were recruited via chart review. We coded data using an inductive approach. Three themes emerged from 29 caregiver interviews: (1) difficulty obtaining assistance, (2) patient harms, and (3) concerns about triage and rooming processes. First, caregivers described having to be proactive to obtain symptom control and assistance with mobility. Second, caregivers observed harms of noise and stimulation provoking agitation and delays in administration of routine medications. Third, caregivers felt it was inappropriate for people with dementia to receive care in waiting room chairs or to receive prolonged hallway care. Caregivers advocated for preferential considerations for rooming and rapid assessment to avoid agitation, facilitatd access to ED staff, and promote patient comfort. Caregivers of people with dementia associated ED environments with difficulty obtaining assistance, patient harms, and triage concerns. Strategies to mitigate the negative impacts of ED crowding on people with dementia should focus on environmental modifications, uptriage of people with dementia, supporting activities of daily living and mobility, and innovation around patient disposition.
Keywords
Humans, Dementia, Caregivers, Emergency Service, Hospital, Female, Male, Qualitative Research, Aged, Middle Aged, Aged, 80 and over, Interviews as Topic, Crowding, Adult, Dementia, Caregiver, Care partner, Emergency department, Acute care, Crowding
Published Open-Access
yes
Recommended Citation
Chary, Anita N; Suh, Michelle; Bhananker, Annika; et al., "Experiences of the Emergency Department Environment: A Qualitative Study With Caregivers of People With Dementia" (2025). Faculty and Staff Publications. 3899.
https://digitalcommons.library.tmc.edu/baylor_docs/3899