How do emergency care needs differ for PLWD differ from other patients in the ED?
What components of ED care improve patient-centred outcomes for PLWD?
Possible components may include: ED environment, patient length of stay in the ED, evaluation and identification of delirium, assessment and treatment of pain, management of agitation, scheduling outpatient follow-up, etc.
What patient-centred metrics best measure the impact of ED interventions for persons with dementia?
Does optimal ED care prevent incident delirium for PLWD in the ED?
How does severity of dementia and presence of other health issues impact the optimal delivery of ED care for PLWD?
How do social determinants of health such as race, ethnicity, wealth and access to medical care impact delivery of optimal ED care for PLWD?
How frequently are PLWD evaluated for delirium in the ED?
How accurately do ED clinicians identify delirium in PLWD in usual practice?
What is the accuracy of delirium identification tools for PLWD in the ED?
How can rapidly progressive dementia be identified in the ED? Should patients with rapidly progressive dementia be admitted for expedited workup?
What are the best pharmacological and non-pharmacological strategies to manage agitation and other behavioural concerns for PLWD in the ED?
How adequately is pain controlled in the ED for PLWD?
How frequently are alternative measures for pain assessment such as the Behavioural Pain Scale, or Critical Care Pain Observation Tool used in the ED for PLWD?
How frequently are alternative measures for pain assessment such as the Behavioural Pain Scale or Critical Care Pain Observation Tool taught to emergency clinicians?
How accurate are screening techniques which are commonly used ED for PLWD? Commonly used screening techniques may include techniques to identify delirium, pain, depression and abuse.
What are the knowledge and training gaps for emergency clinicians and non-clinical staff regarding optimal care of PLWD? Non-clinical staff may include personnel such as security, and registration.
How can emergency clinicians best interact with care partners to provide optimal ED care for PLWD?
How does care partner involvement impact ED care for PLWD? Are these impacts different when care partners are present compared with paid caregivers?
What are the impacts of pragmatic approaches to providing acute unscheduled care such as home care, community paramedicine, telemedicine or three-dimensional telemedicine on patient-centred outcomes for PLWD?
How do emergency clinicians best connect PLWD with community resources?
When concern for dementia or cognitive impairment is identified in the ED, how do clinicians address concerns with patient autonomy and capacity? Should these concerns be reported to anyone? For example, the patient’s family, primary care clinician or adult protective services.
