The viewpoint of emergency medicine specialists and residents in turkey about geriatric patients

Introduction: Elderly population has become the fastest growing group among the other age groups in Turkey and in the world due to such factors as contributions of the technological developments to living conditions, positive developments in health care, reduction in fertility in many countries, decrease in child mortality rates, control of infectious diseases and increased educational level of society. The existing health services with a focus on young people are inadequate to meet the needs and to detect the complex health problems of elderly patients. Although the emergency physicians are the physician group that faces elderly patients most, as compared to other physician groups, their approach, requests, learning situations and problems regarding this issue are not well known.In our study, perspectives and approach of the emergency medicine physicians towards geriatric patients are analyzed. The results obtained from this study are aimed to create guidelines for developing an emergency medicine curriculum and for increasing the quality of patient care.Material and Method: Our study is a descriptive research that was designed as a survey. Polls were delivered to the participants? e-mail addresses from the web address http://www.tatd.in/redcap/ (www.acilarastirma.net) between 22.02.2012 to 22.03.2012. Our data and the statistical analysis of the data were recorded to SPSS for Windows 15.0 program (SPSS Inc.®, Chicago, ABD). The Chi-square, Continuity Correction and Fisher's Exact Test was used to find the relationship between the parameters.Results: 74.7% of the participants? work institution didn?t have geriatric discipline and service. University hospitals were mostly found to have branch of science and service in geriatrics, and that was significantly higher compared to other hospital types (Chi-Square Test, p<0.05). 79.4% of the respondents said that hospitalization of the elderly patients is more difficult compared to the young people in their hospital. 60.5% of participants replied that there is no branch of science in geriatrics in their hospital. Deterioration in general condition, symptoms of the respiratory and neurological system diseases were the most common symptoms of the elderly patients in emergency departments. 37.3% of the residents and 13.1% of the specialists said that they had no education about geriatrics. There was difference between these two groups statistically (Chi-Square Test, p<0.05). The majority of the doctors described that they had training in geriatrics occasionally and they showed interest to be trained in the form of a special mention of cases among the geriatric patients at the end of each course. Rates of the participants having experience in clinical practice and in communication with elderly patients were 68.2% and 67%, respectively. There was difference between the participants? feelings of competence and their experience in emergency medicine statistically. Participants wanted to be trained about drug interactions in elderly, communication with elderly and elder abuse. The study showed that 54.1% of the respondents thought that elderly patients were a part of causes for emergency overcrowding whereas 57% said the increasing number of elderly patients was a threat for emergency departments. It was interesting to see that 90.9% of the participants were of the opinion that home care services reduce emergency room overcrowding. Another interesting finding of the study was that the 68.9% of the respondents told that they met a patient with elder abuse. 72.8% of the participants said, when an elderly patient having no oncological disease or end-stage disease required resuscitation, they wouldn?t feel reluctance. 62.2% of the respondents agreed that geriatric emergency medicine fellowship is not necessary.Conclusion: Elderly patients are a special group of the population. Studies, health and social services for this special group are still inadequate. Emergency medicine doctors in Turkey are aware of the problems caused mainly by the increase in the number of elderly patients. The findings of this study suggest that in order to reduce the problems created by overcrowd of the elderly patients in emergency departments, the following measures be taken:Firstly, the level of training related to elderly patients should be increased substantially, and a new curriculum for training in this field developed.