Balancing Cure and Care for Geriatric Patients With Frailty in Emergency Care: A Qualitative Study.

Introduction: With age, people often develop multiple health problems, chronic illnesses, and frailty. For geriatric adults with frailty, there is a complex interplay of medical, psychological, cognitive, functional, and social issues. As a result, even a minor medical event can disrupt the delicate balance of their condition, often leading to admission to the emergency department. However, frailty can lead to an unpredictable course of symptoms and treatment. Emergency care professionals, including emergency medical services providers and ED staff, are the first to interact with and assess these patients. Therefore, this study aimed to explore the challenges that emergency medical services and ED professionals encounter when caring for geriatric patients with frailty and how they experience these challenges.

Methods: A multicenter qualitative study was conducted. Twenty-two emergency care professionals working in emergency medical services and ED settings were interviewed. The reflexive thematic analysis method, as developed by Braun and Clarke, was used for the analysis. Data collection and analysis were iteratively performed.

Results: The analysis revealed the overarching theme of balancing cure and care, which is explained by the subthemes: the complexity of care, a protocol-driven approach vs a holistic approach, and frustration when care needs exceed system capabilities and protocols.

Discussion: Emergency care professionals experience challenges balancing cure and care for geriatric patients with frailty owing to the fast-paced, diagnosis-focused culture of emergency care. Frustration arises when they are unable to provide the quality of care they believe patients need. Empowering emergency care professionals to take a leading role in delivering holistic care, providing specialized geriatric education, and developing tools to assess and treat patients with frailty more effectively can contribute to better care. Transitioning toward geriatric-friendly emergency departments and implementing geriatric emergency medicine programs could help improve care quality and reduce provider frustration.