Background: Introduction : A Medical Orders for Scope of Treatment (MOST) form, adopted by the state of Texas in 2014, is similar to Physician Orders for Life Sustaining Treatment (POLST/MOLST) form in other states. It translates patient preferences for CPR, critical care, assisted nutrition, and transfer between healthcare facilities into a physician order set. Previous [...]

Background: As the United States population ages the health care system is experiencing overall change and growth in the patient population as evidenced by the rising demand of psychiatric care in the emergency department. By the year 2029 “baby boomers” or older adults, those born between mid-1946 through mid-1964, will be 65 and older resulting [...]

Background: Delirium is a common and costly occurrence in hospitalized patients, particularly elderly patients. Diagnosing delirium can be challenging, particularly given the fluctuating nature of presentation and subtle hypoactive motor subtypes. The Brief Confusion Assessment Method (bCAM) is a delirium screening tool that has been validated for use in the med-surg clinical area. As part [...]

Background: In medical care for older patients, the presence of potentially inappropriate medications (PIMs) is associated with increased adverse outcomes [1, 2]. A wide range of medications with anticholinergic properties affects cognitive states of older patients have been regarded as PIMs [1, 3]. We purposed to assess clinical impact of anticholinergic cognitive burden on clinical [...]

Background: Although many older adults will be hospitalized in their lifetime, most do not consider or plan ahead for their post-hospitalization support needs. When older adults experience a hospitalization, families often must react to the crisis leaving the older adult out of the decision process (e.g. choosing a skilled nursing facility, caregivers). With PCORI funding, [...]

Background: The relation of a patient’s age to survival in cardiac arrest is often discussed at the bedside when clinicians, patients, and families are faced with the question of whether CPR is medically appropriate for elderly individuals. Few studies are available to help guide this conversation. This study sought to evaluate in-hospital cardiac arrest (IHCA) [...]

Background: Atrial fibrillation (AF) is strongly age-dependent, and with a growing geriatric population, the incidence and prevalence of AF is expected to increase in the United States. As a result, the number of patients at risk of a thromboembolic event due to AF is also expected to increase. Although bleeding associated with mechanical falls is [...]

Background: Delirium is associated with increased morbidity, mortality and health care costs in the hospital setting secondary to increased length of stay and poor long term outcomes (1,2). A systematic review of different delirium prediction models found limitations with these models including derivation from small patient populations, lack of heterogeneity, accuracy and reliability as noted [...]

Background: While delirium may affect patients of any age, delirium prevention and management protocols have focused mostly on the elderly, as older adults (>65 years old) are more vulnerable to developing delirium. Delirium has been reported in 19-31% of younger adults during their hospital stay, and 15-56% of older adults.There is lack of literature on [...]

Background: Although hip fractures in the elderly are largely due to osteoporosis, rates of treatment for osteoporosis after fragility fracture have been reported as