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Older people presenting to acute care hospitals 

Older people presenting to acute care hospitals
Chapter:
Older people presenting to acute care hospitals
Author(s):

Roger Y. M. Wong

DOI:
10.1093/med/9780198701590.003.0034
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date: 23 October 2019

Older people presenting to acute care hospitals are at risk of developing adverse events. Comprehensive geriatric assessment (CGA) in acute care provides standardized assessment and management of geriatric problems. The emergency department is a common point of entry, and strategies that focus on enhancing expertise, equipment, policies, and protocols are helpful. The geriatric consultation service model is commonly deployed, and the geriatric evaluation and management unit (GEMU) is a common ward-based model. The acute care for elders (ACE) unit model is associated with fewer adverse events, less functional decline, shorter hospital length of stay, lower institutionalization risk, and lower cost. The senior friendly hospital (SFH) model requires further studies to confirm its effectiveness. A number of geriatric post-discharge liaison services can smooth the transition of older people returning to the community. Overall these models of care are not mutually exclusive, but together they comprise the best practice for older people.

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