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Geriatrics and Palliative Care

Wednesday June 16

Track Chairs

Debra Eagles


Christian La Riviere


Emergency Physician, The Ottawa Hospital
Associate Professor, University of Ottawa
Associate Scientist, Ottawa Hospital Research Institute
Past Chair, CAEP Geriatric Emergency Medicine Committee

Emergency physician at the Health Sciences Centre in Winnipeg, Palliative Care Consultant and Medical Director for the WRHA Palliative Care Program. Current Chair of the CAEP Palliative Emergency Care Committee.

Interdisciplinary Pearls in the Evaluation of Older ED Adults

Learning Objectives

Understand the intersection of the frail older adult and their acute ED presentation.

2. To provide ED clinicians with pearls from an interdisciplinary panel, that can be immediately integrated into their clinical practice.

Occupational Therapy in the Emergency Department

Occupational therapists in the emergency department focus on the function of patients, including what they need to do to be discharged safely and what they can do in the ED. This helps to inform disposition planning from the ED, particularly for frail older patients.

Medication Management Considerations in the Frail Older Adult

Adverse drug events (ADEs) are common in older persons and can lead to serious harm or death. A team approach to medication management can increase awareness of ADEs as presenting diagnoses, avoid drug interactions, minimize the use of potentially inappropriate medications and positively influence the care of older persons.

Learning Objectives

Recognize serious drug interactions associated with adverse drug events leading to hospitalization in older adults
Use a comprehensive approach to improve identification and prevention of adverse drug events
Implement strategies to enhance medication safety for transitions out of emergency


A comprehensive and accurate medication history can aid in identifying medications that increase the risk of adverse drug events
Pharmacists are a resource for medication assessment and management of high risk older patients in the ED
Engage a multidisciplinary care team to assist with medication management at transitions of care

Key aspects of managing frail older adults in the Emergency department

Learning Objectives
To understand the importance of the ascertaining the baseline state in older adults who are acutely ill.
To review the common ways that severe illness manifests in older people who are frail at baseline.
To consider how exercising humility and taking advantage of the early response to treatment can help improve critical decision-making.

Palliative Care

The palliative care portion of this track will provide a high yield review of management of common scenarios found in the ED. This includes how to effectively withdraw life sustaining measures and the use of common medications for effective symptom management in the palliative setting.

Learning Objectives

Illustrate an approach to withdrawal of life sustaining measures in the ED

Recognize and order appropriate medications for symptom management in patients requiring palliative support

Palliative Care Orders in the ED

In this presentation, we will discuss common symptoms that patients with advanced illness experience, and provide a toolbox of medications for patients presenting to the emergency department.

Learning Objectives

Discuss palliative admission orders

Discuss orders for the actively dying patient

Discuss orders for catastrophic terminal events

Withdrawal of Life-Sustaining Therapy in the ED

Sometimes when a patient presents to the Emergency Department (ED) in extremis, rather than resuscitation, the goal of everyone involved is to help the patient die in a comfortable and dignified fashion. This talk will review the process of withdrawing life-sustaining measures (WLST) and allowing a patient to pass away in the ED.

Learning Objectives

Appreciate the importance of involving organ donation organizations prior to WLST.
Recognize when WLST in the ED might be appropriate.
Understand and be able to anticipate for families what might occur at WLST.


Assess whether family would be open to involvement of the local organ and tissue donation agency prior to WLST.
Prepare families for what they might see during WLST.
Spend some time in the room.