Management of Demented Patients in Emergency Department

Abstract

The hospitalization of the elderly with acute illness is one of the most discussed in the organization of health services, it is not yet clear whether the hospital is really the best response to the needs of the elderly, especially those with cognitive impairment. Despite evidence of possible adverse effects of hospitalization (immobilization, acute confusional state resulting in sedation, risk of falls, intestinal sub-ileus), there has been an increasing use of the hospital, particularly to specialist services. Regardless of the benefits from the shelter (instrumental diagnosis and prompt treatment of acute somatic disease), in people with dementia it needs to identify the characteristics of the person (cognitive impairment, functional status, somatic comorbidity, social and familial status), the personal needs and, therefore, diagnostic and therapeutic targets which must be assumed for that sick person during hospitalization. To this end, it is fundamental the role of assessment and diagnostic orientation that takes place in the Department of Emergency and Acceptance (DEA), which mainly receives patients at the hospital. Even before the hospital recovery it is therefore essential to check how many elderly patients with cognitive impairment that belong to the DEA, and what are their needs.