Unplanned, urgent and emergency care: what are the roles that EMS plays in providing for older people with dementia? An integrative review of policy, professional recommendations and evidence
Buswell, Marina Lumbard, Philip Prothero, Larissa Lee, Caroline Martin, Steven Fleming, Jane Goodman, Claire
Buswell, Marina
Lumbard, Philip
Prothero, Larissa
Lee, Caroline
Martin, Steven
Fleming, Jane
Goodman, Claire
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Abstract
Objective To synthesise the existing literature on the
roles that emergency medical services (EMS) play in
unplanned, urgent and emergency care for older people
with dementia (OPWD), to define these roles,
understand the strength of current research and to
identify where the focus of future research should lie.
Design An integrative review of the synthesised
reports, briefings, professional recommendations and
evidence. English-language articles were included if they
made any reference to the role of EMS in the urgent or
emergency care of OPWD. Preparatory scoping and
qualitative work with frontline ambulance and primary
care staff and carers of OPWD informed our review
question and subsequent synthesis.
Results Seventeen literature sources were included.
Over half were from the grey literature. There was no
research that directly addressed the review question.
There was evidence in reports, briefings and professional
recommendations of EMS addressing some of the issues
they face in caring for OPWD. Three roles of EMS could
be drawn out of the literature: emergency transport,
assess and manage and a ‘last resort’ or safety net role.
Conclusions The use of EMS by OPWD is not well
understood, although the literature reviewed
demonstrated a concern for this group and awareness
that services are not optimum. Research in dementia
care should consider the role that EMS plays, particularly
if considering crises, urgent care responses and
transitions between care settings. EMS research into new
ways of working, training or extended paramedical roles
should consider specific needs and challenges of
responding to people with dementia.
https://emj.bmj.com/content/emermed/33/1/61.full.pdf
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/emermed-2014-203941