General approach to the geriatric patient

Introduction. The emergency department approach to the geriatric patient is different than the traditional approach to younger emergency patients, and requires an evaluation combining medical, functional, and psychosocial issues. This chapter will also review the processes which make the geriatric patient susceptible to disease yet lack the typical symptoms and signs of life-threatening illnesses. Principles of geriatric emergency medicine. Emergency medicine (EM) is a specialty focused on chief complaints to identify life- or limb-threatening problems as well as urgent disease processes that require immediate attention. A focused history and physical exam, as is the norm for most emergency department (ED) visits, may not be adequate for many elders. Generally, the aging population presents with less specific and localized complaints. Adding to this difficulty is that of obtaining a history in some elder patients who may have cognitive or hearing impairment [1]. Geriatric patients are at increased risk for return visits, misdiagnosis, hospitalization, morbidity, and death [2]. Mortality due to acute coronary syndrome (ACS), appendicitis, sepsis, and trauma, as well as many other conditions, is significantly increased in elders compared with that of the younger population [3]. An appreciation of the importance of the multiple factors, related acute exacerbations of chronic disease, and social and functional issues is required to address the elder in the ED in a meaningful way [4].