Person-centred decisions in emergency care for older people living with frailty: principles and practice

Emerg Med J. 2024 Oct 23;41(11):694-699. doi: 10.1136/emermed-2024-213898.

Abstract

Older people living with frailty are frequent users of emergency care and have multiple and complex problems. Typical evidence-based guidelines and protocols provide guidance for the management of single and simple acute issues. Meanwhile, person-centred care orientates interventions around the perspectives of the individual. Using a case vignette, we illustrate the potential pitfalls of applying exclusively either evidence-based or person-centred care in isolation, as this may trigger inappropriate clinical processes or place undue onus on patients and families. We instead advocate for delivering a combined evidence-based, person-centred approach to healthcare which considers the person's situation and values, apparent problem and available options.

Keywords: emergency departments; ethics; frailty; geriatrics.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Decision Making
  • Emergency Medical Services / methods
  • Emergency Medical Services / standards
  • Emergency Service, Hospital / organization & administration
  • Female
  • Frail Elderly*
  • Frailty / complications
  • Humans
  • Male
  • Patient-Centered Care*