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Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review

2022; Elsevier BV; Volume: 23; Issue: 8 Linguagem: Inglês

10.1016/j.jamda.2022.02.024

1538-9375

Christopher R. Carpenter, Jesseca Leggett, Fernanda Bellolio, Marian E. Betz, Ryan M. Carnahan, David B. Carr, Michelle Doering, Jennie Chin Hansen, Eric Isaacs, Deborah Jobe, Kathleen Kelly, Nancy Morrow‐Howell, Beth Prusaczyk, Bob Savage, Joe Suyama, Allan S. Vann, Kristin L. Rising, Ula Hwang, Manish N. Shah, Neelum Aggarwal, Heather Allore, Amy Aloysi, Michael Belleville, Fernanda Bellolio, Marian E. Betz, Kevin Biese, Cynthia Brandt, Stacey Bruursema, Ryan M. Carnahan, Christopher R. Carpenter, David B. Carr, Jennie Chin‐Hansen, Morgan Daven, Nida Degesys, M. Scott Dresden, Jeffrey Dussetschleger, Michael Ellenbogen, Jason R. Falvey, Beverley Foster, Cameron J. Gettel, Angela Gifford, Andrea Gilmore‐Bykovskyi, Elizabeth M. Goldberg, Jin H. Han, James Hardy, Susan N. Hastings, Jon Mark Hirshon, Ly Hoang, Teresita M. Hogan, William W. Hung, Ula Hwang, Eric Isaacs, Naveena Jaspal, Deb Jobe, Jerry Johnson, Kathleen Kelly, Maura Kennedy, Amy Kind, Jesseca Leggett, Michael Malone, Michelle Moccia, Monica Moreno, Nancy Morrow‐Howell, Armin Nowroozpoor, Ugochi Ohuabunwa, Brenda Oiyemhonlan, William Perry, Beth Prusaczyk, Jason Resendez, Kristin L. Rising, Mary Sano, Bob Savage, Manish N. Shah, Joseph Suyama, Jeremy Swartzberg, Zachary Taylor, Vaishal Tolia, Allan Vann, Teresa Webb, Sandra Weıntraub,

Family and Patient Care in Intensive Care Units

ObjectivesTo synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research.DesignSystematic scoping review.Settings and ParticipantsPLWD and their care partners in the ED setting.MethodsInformed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized.ResultsFrom 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication.Conclusions and ImplicationsResearch exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.