Residential aged care homes: Why do they call '000'? A study of the emergency prehospital care of older people living in residential aged care homes.
Emergency medicine Australasia · 2020-10-10 · Observational study
Abstract
OBJECTIVE: To describe the clinical characteristics, medical interventions and patterns of ambulance service use related to the emergency, prehospital care of older people living in residential aged care (RAC) homes. METHODS: Retrospective cohort study using secondary analyses of routinely collected clinical and administrative data from Ambulance Victoria and population data from the Australian Bureau of Statistics for the state of Victoria, Australia. Participants included people aged 65 years and over, attended by emergency ambulances from 2008 to 2013, with data captured in the Ambulance Victoria electronic record. RESULTS: The mean (standard deviation) age of RAC residents attended by emergency ambulance was 85 (7.3) years and 63% were women. Common comorbidities included dementia (32.7%), ischaemic heart disease (27.7%) and osteoarthritis (24.6%). Polypharmacy was prevalent with 70% currently prescribed antibiotics, over 20% prescribed sedatives and a further 14.9% antipsychotics. Fifteen percent of attendances were for falls, which were more frequent among women than men. Other common reasons for ambulance call-out included uncontrolled pain, respiratory tract infection, non-specific febrile illness and altered conscious state. Almost 90% of people were transported to hospital from the RAC, with just over half of call-outs occurring out-of-hours. CONCLUSION: This is the first study to describe emergency prehospital care, case-mix and intervention of frail, older people living in RAC. These results demonstrate a clinically complex group of people with high rates of comorbidity, cognitive impairment and polypharmacy. These valuable data will inform education and training of prehospital clinicians, assist in targeting preventative medicine and primary care programmes and further development of alternate, acute and emergency care pathways for this unique patient group.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Older adults · Nursing & care homes
Related articles
- Ambulance Responses to Falls Incidents in Queensland Residential Aged Care Facilities: Implications for Policy and Practice. (Australas J Ageing, 2026)
- Exploring Population Characteristics and Recruitment Challenges in Older People Experiencing Falls at Home without Hospitalization or with an Emergency Department Visit: Insights from the RISING-DOM Experience. (Clin Interv Aging, 2023)
- Can EMS providers and emergency department nurses work together to identify home risk factors for falls in older people? (Medicine (Baltimore), 2022)
- Development of a Content Valid and Reliable Prehospital Environmental Falls Risk Assessment Tool for Older Adults. (Prehosp Emerg Care, 2020)
- The epidemiology of elderly falls attended by emergency medical services in Victoria, Australia. (Injury, 2018)
- Surveying the quality of prehospital emergency services for the elderly falls 2017. (J Educ Health Promot, 2018)