Wednesday, May 29, 2019 • 10:45 - 12:15
Track 3 - Geriatric EM: Creating a Senior-Friendly ED; Patient Experience; ED Patients with Dementia
Track Chair: Dr. Doug Sinclair
Room: 202

Pearls and Pitfalls in the ED Management of Chronic Brain Failure - Dr. Rob Anderson

Description: What is chronic brain failure and why should I care? Dementia patients must have a terrible quality of life, right? Why would I even consider offering an invasive procedure for someone with dementia? Answers to these questions and more during this discussion of acute management of chronic brain failure.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Develop an understanding of chronic brain failure (dementia), integrate that into their practice.
  2. Demonstrate an approach for the acute management of people with chronic brain failure.
  3. Formulate a plan to advocate for the care of people with dementia who may benefit from an emergent intervention or admission.


  1. Dementia is not a four-letter word; it is simply a different way of looking at the world.
  2. Function is king; dementia is only one aspect of someone’s functional status.
  3. Dementia is not a contraindication for surgery, cardiac catheterization, or any other medical therapy.

Dr. Anderson is a board-certified internist and emergency physician. His primary academic interest is the care of older adults. He teaches emergency, internal, and family medicine residents. He currently works as an Emergency physician at a busy level one trauma center in Maine, is the director of a house call program, and provides primary care to older people in long-term care and other institutional settings.

Hearing the Patient’s Voice: They Have Wisdom to Share - Ms. Joanne Redgrave, Ms. Diana Lawlor, Dr. Doug Sinclair (moderator)

Description: This will be an interactive presentation (panel and Q and A from audience) on patient experience.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Appreciate the patient/caregiver perspective with respect to the ED experience.
  2. Describe 2 communication techniques to improve patient discharge from the ED.

Joanne Redgrave is a retired public school teacher with teaching experience encompassing refugee chidden, students with special needs and early learners. Her attention has shifted to the other end of the life cycle as she helps her elderly parents live as independently and joyously as possible. She is a member of the Halifax Infirmary Emergency Dept. Frailty Committee.

Diana is a graduate of Dalhousie University School of Nursing and works as a Nurse Practitioner and Program Coordinator with the Obesity/Bariatric Surgery Team at the QEII Health Sciences Center/Capital Health. She has been a speaker with a number of local, national and international conferences and events and is passionate regarding enhancing health care for Nova Scotians and Canadians. On a personal note –Diana is a member of the sandwich generation and is a constantly rising to the challenge of managing a career, busy family and her Mom who has a complex neurological disease.

Dr. Sinclair is an emergency physician at the Nova Scotia Health Authority, and the IWK Health Centre in Halifax, and is also on staff at St. Michaels Hospital and is a full professor of Emergency Medicine at the University of Toronto. Dr Sinclair is former chief of three separate EDs, recently retired from the positions of executive vice-president and Chief Medical Officer at St. Mike’s. He is a past university department chair and a former CAEP president. And currently a proud and happy grandfather.

Are You a Senior-Friendly ED? Are You Ready for Accreditation? - Dr. Don Melady

Description: Many EDs, large and small, wonder what about practical changes they can make to provide better care to older patients. This presentation will review a range of innovations — big and small — to do that and also to earn the designation “Accredited Geriatric ED.”

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Identify the core attributes of a senior-friendly ED.
  2. Access guidelines and resources to guide senior-friendly change.
  3. Use accreditation criteria to develop a vision for geriatric care at your home ED.


  1. Make a pitch to your hospital admin to increase interdisciplinary — PT, OT, SW — assessment in the ED.
  2. Make some low-cost additions to your physical environment — add walkers, hearing assists, comfort food.
  3. Work with your hospital volunteer programme to train geriatric-focussed volunteers to improve patient experience.

Don Melady is an Emergency Physician at Mount Sinai Hospital Toronto where he focuses his academic activities on Geriatric EM. He is a lead of the Geriatric ED Collaborative, a project to support hospitals and health care systems to implement senior-friendly QI projects in EDs. He is on the board of the Geriatric ED Accreditation project of ACEP to recognize exemplary care of older people in EDs.