Care transition decisions after a fall-related ED visit: A qualitative study of patients’ and caregivers’ experiences
Academic Emergency Medicine Feb 17, 2020
Gettel CJ, et al. - As falls are a preeminent cause of injury-related emergency department (ED) visits and may serve as a sentinel event for older adults, resulting in physical and psychological injury, researchers here sought to identify patient- and caregiver-specific perspectives concerning care transitions after a fall. From the Geriatric Acute and Postacute Fall Prevention Intervention trial, participants aged 65 years and older that had an ED visit for a fall and their caregivers were assessed with in-depth, qualitative interviews using a semi-structured interview guide employing grounded theory methodology. They identified completion of a total of 22 interviews, with 10 patients, eight caregivers, and four patient-caregiver dyads within the 6-month period after initial ED visits. The analysis revealed that after a fall, older adults experienced physical limitations and had a prominent fear of falling after their injury. A vital role of caregivers is suggested in securing the home environment, the skilled nursing facility (SNF) placement decision-making process, and navigating the transition of care between the ED, SNF, and outpatient visits after a fall. In older adults seeking ED care following a fall, they suggest anticipating and addressing the feelings of isolation, changes in mobility, and fear of falling.
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