Table 4.

Quotations Illustrating Theme 4: Options to Prevent and Address Acute Care Needs of Persons with Dementia

#	Quote
27	“So the absolute key for these patients is upstream interventions. And I think we have some upstream interventions for some supportive care but I don’t know if we have a medical upstream intervention. Our upstream intervention has been “Call 911”…And I think that’s hard…human nature is we kind of try to do all we can, until it kind of hits crisis mode.” (geriatric healthcare provider, ID 16)
28	“So maybe education of caregivers-that these are not reasons to call the ambulance or reasons to take somebody to the hospital. It’s maybe having a point person for these people…here’s what you need to do in the future.”(community paramedic, ID 12)
29	“The other thing is you’ll see a person come in, the family member sends them in, but the person has no insight, so the doc [PCP] takes what information they’re given, and acts upon it. But they didn’t know that the patient got lost two days earlier. So the patient tells them what they think- like what they know, so the doc doesn’t always get what they need to do.” (aging service provider, ID 23)
30	“We have really great primary care [where I practice] even though it’s busy…there’s very likely a nurse practitioner or physician assistant available; our patients don’t have to go to the ER generally because…they can’t get an appointment with us, and then there’s also the [blinded] urgent care as well, so I don’t see…patients in my practice setting doing that a lot. But I mean I know of it happening, I know of it happening…[in] practice settings where I’ve worked.” (PCP, ID 10)
31	“…when it comes to the evenings or the weekends…you’re probably better off starting at urgent care [rather than calling the PCP].” (geriatric healthcare provider, ID 17)
32	“…there’s a geriatric ED…[or] seeing more of these patients cared for in the community, in their own homes, I think assuming that there wasn’t something specific from the hospital they needed, is generally a good thing.” (ED physician, ID 21)
33	“It’s been wonderful to be able to tap into [hospice] because…they came right away, and showed us how to dress him, and showed us like what to do…I think having the people come to the house where he’s sitting in his comfortable chair, and it’s a much more quiet environment, I think makes a huge difference.” (caregiver, ID 15)
34	“There may be 911 calls that happen because of a fall, and they don’t necessarily automatically have to be taken to the ED. An assessment can happen where the patient and the paramedic are able to determine that it was simply a mechanical fall, and see what we can do to help prevent that from happening again. They have coordination with a clinician if they have questions to verify and make sure that they don’t need to be seen urgently or have a medical assessment…if a community paramedic is going to visit them, then they can relay to us what’s going on, we might be able to work together to help prevent them from having to go to the ED.” (PCP, ID 10)
35	“I think at least having some knowledge of what kinds of services are available and what the possibilities are might be helpful…we have social workers that know this stuff…. So I can say y’know Mrs Smith over there she needs help…But other emergency departments don’t have that luxury. I think it would be helpful to have some overview of what kind of services would be available.” (ED physician, ID 1)