Understanding barriers to goal-concordant care for older adults with serious illness in the pre-hospital setting during emergency response call-outs: a multi-site qualitative study

Lauren Pollack, MD, MS
University of Washington, Alzheimer's Disease Research Center (ADRC)

Elizabeth Dzeng, PhD, MD, MPH
University of California, San Francisco, Claude D. Pepper Older Americans Independence Center (OAIC)
Project Description:
Emergency Medical Services (EMS) providers are first to respond when older adults with dementia experience medical emergencies and 911 response is activated. This study explores communication between EMS providers, patients, and their healthcare decision-makers during medical emergencies. Our goal is to identify opportunities to improve communication and ensure that treatments started in the pre-hospital setting are in line with patient preferences. By interviewing family decision-makers and observing EMS teams in action, we aim to understand what works well and what could be improved in terms of communication about treatment plans during 911 response.
Potential Impact:
We believe communication between patients with dementia (when able), their healthcare decision-makers, and clinicians during times of crisis has important implications for the quality of care delivered and the experience of patients and their family members. We are excited about the potential to identify opportunities to improve communication during these moments which can be very stressful for patients and their families and during which important treatment decisions are frequently made.
Next Steps:
Our findings will inform the development of interventions to improve communication for people with dementia and their family members when acute health concerns arise.
The importance/value of RCCN funding for this collaborative research:
Working together across institutions and geographic locations is challenging without resources to facilitate such collaborations. Funding from RCCN allows us to synergize efforts across institutions and cities to improve care for people with dementia and their families.