Older patients scoring 4-9 on the CFS are identified as having an increased risk to adverse outcomes and will require a comprehensive assessment to determine specific care needs. The primary ED clinician should complete a modified comprehensive geriatric assessment (mCGA) and can be supported by trained geriatric specialists from the Geriatric Emergency Department Intervention (GEDI) team.
The key domains for assessment for every frail older person are:
- pressure injury identification
- cognition appropriate pain assessment
- oral food and fluid intake
- falls risk.
Geriatric Emergency Department Intervention
The GEDI model provides specialist and targeted care for older persons attending the Emergency Department (ED), by front-loading frailty assessments, prioritising care needs and fast-tracking frail older persons through the ED.
The team works in a multidisciplinary approach to the screening, assessment and care planning of frail older people, to ensure appropriate and coordinated care. They aim to streamline efficient ED processes leading to discharge home or to the ward in a timely manner to improve health outcomes. You can find more information in the attached resources, including the steps to take when discharging an older person from ED who has been assessed as frail.
The following tools have been developed to improve targeted assessment of frail older persons to identify and meet care needs.
GEDI tool kit
The GEDI toolkit assists facilities in implementing the GEDI.
Brochures promoting the goals and benefits of GEDI
Care of the older person in emergency
The care of the older person in emergency module was developed to support increased understanding of the anatomical, physiological, pharmacological and psychosocial differences older people have compared to younger adults.
The module addresses common ED presentations by older people and explains the interesting changes in this age group making it important to holistically address the impacts of conditions on the older person rather than addressing isolated body systems.