GERIATRIC EM
Communicating with Older Adults in the Emergency Department
SAEM PULSE | JULY-AUGUST 2022
By Surriya Ahmad, MD on behalf of the SAEM Academy of Geriatric Emergency Medicine
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On any given shift, the groups of people an emergency physician communicates with can be broken down into at least three large categories: between departments, intradepartment, and with patients and families. Communication breakdown (i.e., miscommunication) can happen in any one of these groups; likewise, compromise in the ability to communicate in any one area can lead to preventable medical errors and affect patient care. Although one may find that communication in one area poses problems for them, communication in another area may be a strength. There is also evidence that suggests that higher communication competence correlates with higher patient satisfaction,
physician empathy, and lower physician burnout; however, more studies are needed. (AMA, WSJ, NEJM Catalyst, PubMed) There are unique challenges in the emergency department — distractions, volume, lack of space, time — that make communication difficult, especially with older patients. For example, hearing and visual impairment, which make communicating in a noisy emergency department especially challenging, and difficulties with manual dexterity, cognitive impairment, and language barriers. However, there are certain communication tips that can be used with older patients specifically with the aim of improving their experience in the emergency department (the
following are adapted from the American Academy of Family Physicians): • Allow extra time. • Avoid distractions. (In a busy emergency department this is hard; however, it is doable.) Give your undivided attention for the first 60 seconds of the interaction, utilizing the limited time you have and being fully present in the moment. • Sit face to face. • Maintain eye contact and utilize other nonverbal communication. Looks, head nods, body positioning and posture, gestures, facial expressions, and even breathing contribute to the relationship and communication
