Emergency Department Use by Community-Dwelling Individuals With Dementia in the United States: An Integrative Review
Open accessAbstract
As part of the National Plan to Address Alzheimer's Disease, reducing potentially avoidable emergency department (ED) use by individuals with dementia has been identified as a component of enhancing the quality and efficiency of care for this population. To help inform the development of interventions to achieve this goal, an integrative review was conducted to: (a) compare rates and reasons for ED visits by community-dwelling individuals with and without dementia, considering also the effect of dementia subtype and severity; and (b) identify other risk factors for increased ED use among community-dwelling individuals with dementia. Nineteen articles met inclusion criteria. Individuals with dementia had higher rates of ED visits compared to those without dementia, although differences were attenuated in the last year of life. Increased symptoms and disability were associated with increased rates of ED visits, whereas resources that enabled effective management of increased need decreased rates. Gerontological nurses across settings are on the frontlines of preventing potentially avoidable ED visits by community-dwelling individuals with dementia through patient and family education and leadership in the development of new models of care. [ Journal of Gerontological Nursing, 44 (3), 23–30.]
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Existing research found higher emergency department visit rates among people living with dementia with more severe neuropsychiatric symptoms.
“Existing research on associations between individual characteristics of people living with dementia and general use of the ED have found higher visit rates among those with individuals with more severe neuropsychiatric symptoms, higher comorbidity burden, and those living in rural locations.18,19”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [19]
Existing research found higher emergency department visit rates among people living with dementia with higher comorbidity burden.
“Existing research on associations between individual characteristics of people living with dementia and general use of the ED have found higher visit rates among those with individuals with more severe neuropsychiatric symptoms, higher comorbidity burden, and those living in rural locations.18,19”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [19]
Existing research found higher emergency department visit rates among people living with dementia living in rural locations.
“Existing research on associations between individual characteristics of people living with dementia and general use of the ED have found higher visit rates among those with individuals with more severe neuropsychiatric symptoms, higher comorbidity burden, and those living in rural locations.18,19”
From Factors associated with recurrent emergency department visits among people living with dementia: A retrospective cohort study (2023) · cites this paper as [19]
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- Authors
- Hunt, L. J., Coombs, L. A., & Stephens, C. E.
- Affiliations
- San Francisco VA Medical Center (US)
- Venue
- Journal of Gerontological Nursing
- Publisher
- SLACK, Inc.
- Published
- 2018-03
- Volume
- 44
- Issue
- 3
- Pages
- 23-30
- ISSN
- 0098-9134 (ISSN-L)
- 1938-243X
- PMC
- PMC5982587
- OpenAlex
- W2791967588
- Cited by
- 56
- References
- 40
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 6 · 2023: 9 · 2022: 8 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 1
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Gerontological Nursing (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (KL2TR000143)
- University of California, San Francisco
- National Institute on Aging (K76AG054862)
- National Institute of Nursing Research (F31NR015380)
- National Center for Advancing Translational Sciences
- Clinical and Translational Science Institute, University of California, San Francisco
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia, emergency department utilization, community-dwelling older adults, dementia severity, dementia subtypes, geriatric nursing, patient and family education, models of care
- MeSH terms
- Alzheimer Disease, Emergency Service, Hospital, Geriatric Nursing, Humans, Models, Psychological, Risk Factors, Severity of Illness Index, United States, Case-Control Studies, Nurse's Role, Independent Living
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