Nursing home patients with cognitive impairments are more likely to be admitted to emergency departments (ED), according to a recent study published in the Journal of the American Geriatrics Society.

Transfers from nursing homes to EDs or the hospital can have negative long-term impacts on the health of older patients. Approximately 25% of nursing home patients will experience a transfer to the hospital or ED over the course of a year and there is a significant likelihood of reduced functioning and overall negative health impacts after discharge, according to the study. 

Investigators examined hundreds of transfers among 867 long-stay nursing home facility residents to explore how these transfers to the ED affect long term health. 

The study found that most common reasons for transfer from a nursing home to the ED were falls, trauma, fracture, non-gastrointestinal bleeding, and pain. The study showed that residents most likely to be transferred were those with cognitive impairment and respiratory difficulties. 

"Transfers of care can be very difficult on the patient. Our goal in analyzing this data is to identify new opportunities to improve care, whether it's preventing transfers to the emergency department or finding ways to avoid hospital admissions," first author Kathleen Unroe, MD, MHA, Regenstrief research scientist and associate professor of medicine at IU School of Medicine, said in the press release. "This information helps us understand what ailments could potentially be treated in the nursing home, avoiding a potentially risky transfer of care."

The study authors suggest that one course of action is to focus on how to treat falls and symptom management within nursing homes to help reduce transfers. According to the study, another strategy is to help improve the ability of care providers in the ED to assess nursing home residents. 

Reference:
Nursing home residents with cognitive impairment more likely to be admitted to hospital [News Release] October 19, 2020; Indianapolis, IN. https://www.eurekalert.org/pub_releases/2020-10/ri-nhr101920.php. Accessed October 20, 2020