Closing the Care Gap for Seniors After Falls

Original source: https://www.mcknights.com/news/study-finds-major-care-gap-for-seniors-visiting-eds-after-falls/This briefing summarizes a recent multicenter study highlighting a critical disconnect between recommended care guidelines and actual clinical practice for older adults presenting to emergency departments (EDs) following falls. s.I. Significant Gap in Recommended Care vs. Actual Practice:The core finding of the study is a substantial "care gap" for elderly patients experiencing falls. Despite national guidelines advocating for comprehensive assessments, only a small fraction of these vulnerable individuals receive the recommended therapeutic evaluations."A new multicenter study reveals a significant gap between recommended care and actual practice for older adults’ emergency department visits following falls.""Researchers analyzed 945 patients aged 65 and older who presented with fall-related complaints at five hospitals… between 2020 and 2022.""The study found that only 16% of elderly emergency patients received physical or occupational therapy evaluations, despite national guidelines recommending comprehensive assessments for this vulnerable population."This represents a "substantial underutilization of therapy services."II. High Impact and Effectiveness of Therapy Consultations (When Implemented):Despite their underutilization, the study unequivocally demonstrates the high impact and effectiveness of physical and occupational therapy evaluations when they do occur."However, when therapy consultations did occur, they proved highly effective.""According to the research, 76% of physical therapy evaluations and 78% of occupational therapy evaluations resulted in meaningful changes to patient care plans."These "meaningful changes" included a range of crucial interventions such as:Recommendations for different living arrangementsReferrals for home health therapyNew medical equipment (e.g., walkers, safety devices)Strategies for better symptom managementIII. High Medical Complexity of the Patient Population:The study population underscores the vulnerability and complex needs of older adults who experience falls, further emphasizing the necessity of comprehensive care."The patient population studied demonstrated high medical complexity, with 28% having dementia and 67% requiring hospital admission."Among those screened for various geriatric conditions (cognitive impairment, delirium, fall risk, functional problems), a large majority tested positive for at least one issue: "74% tested positive for at least one issue."IV. Inconsistent Implementation Across Hospitals:The study revealed a wide disparity in the rate of therapy consultations among the participating hospitals, suggesting a lack of standardized implementation of care guidelines."Physical and occupational therapy consultation rates varied dramatically between hospitals, ranging from less than 1% to nearly 40% of eligible patients receiving therapy evaluations."This variation "suggests inconsistent implementation of established care guidelines across different emergency departments."V. Conclusion: High Impact, Significant Underutilization:The study's authors draw a clear conclusion: while ED therapy evaluations are highly impactful for older adults who fall, their real-world clinical utilization remains strikingly low."The study authors concluded that ED therapy evaluations for older adults with falls are highly impactful when implemented but remain significantly underutilized in real-world clinical practice."