Geriatrics-friendly EDs may also help older individuals determine their personal “goals of care” and how to achieve them. A discussion about goals of care means that healthcare staff will talk to you about your wishes and values in your life. This discussion can help you decide which treatments you choose for your illness.
One tool for expressing healthcare goals is a legal document called an “advance directive.” Advance directives explain what kind of end-of-life care someone wants or doesn’t want, depending on their personal preferences.
A geriatrics-friendly ED may have a system to consider and document goals of care. This system can include creating or incorporating an advance directive into a person’s medical records. Older adults can help in this process by making sure they tell ED staff their goals of care early. To be prepared in advance for an emergency, older people or caregivers should have a copy of the advance directives handy. If possible, this important paperwork should be brought to an ED visit. Another way to make sure your wishes can be communicated as quickly as possible is to give your advance directive to your day-to-day healthcare team to keep on file.
If you or someone you care for doesn’t have an advance directive, talk with family and others to discuss your goals of care. This way they are as clear as possible before an emergency. A geriatrics-friendly ED will work hard to incorporate these goals into all treatment decisions.
Another thing geriatrics-friendly EDs are good at is balancing treatments that attempt to cure an illness versus managing symptoms. This is particularly true for older adults with advanced illnesses. For example, “palliative care” is specialized care for relieving pain and other symptoms of an illness. Treatment plans may best meet a person’s needs by incorporating palliative care. If you or someone you care for needs emergency care, ask if any ED staff are trained in palliative care. If not, ask if palliative care professionals are available in the ED, hospital, or by outpatient referral.