Examining What Matters to Older Adults with Increased Risk of Adverse Functional Outcomes in Emergency Medicine

<h1>Abstract</h1> <p><strong>Background:</strong> Research has demonstrated that older adults experiencing functional decline are more susceptible to adverse outcomes and diminished quality of life. The Emergency Department (ED), intended for acute care interventions, presents an opportunity to identify and address <em>what matters</em> to ED patients.</p> <p><strong>Purpose: </strong>The purpose of this study was to describe <em>what matters</em> to older adults at risk for functional decline. The research question was: <em>What matters</em> to older adults at risk of functional decline?</p> <p><strong>Lines of Inquiry:</strong> The lines of inquiry for this study included describing <em>what matters</em> during an ED visit among older adults at risk of functional decline, as well as describing <em>what matters</em> in life to older adults at risk of functional decline.</p> <p><strong>Rationale: </strong>The rising trend of ED visits by older adults at risk for functional decline presents a critical demand in healthcare to understand <em>what matters</em> to this population, develop interventions, provide resources, and support care that aligns with personal values.</p> <p><strong>Methods:</strong> This study used content analysis as a methodology and an approach for data analysis. Older adults screened at risk for adverse functional decline using the Identification of Seniors at Risk instrument are routinely seen by a Geriatric Emergency Nurse for a comprehensive geriatric assessment, including semi-structured questions adapting <em>what matters</em> conversations to <em>what matters</em> during their present ED visit and <em>what matters</em> in life. Retrospective data from Electronic Health Records were analyzed.</p> <p><strong>Findings:</strong> The content analysis methodology and approach to data analysis yielded five major themes addressing the two lines of inquiry. Three major themes were identified for the first line of inquiry <em>what matters</em> during an ED visit: (a) health and well-being, (b) health management and (c) autonomy. In the second line of inquiry, two major themes were identified for <em>what matters</em> in life: (a) connections, and (b) health and well-being.</p> <p><strong>Implications:</strong> Study findings suggest that further research is needed in healthcare to understand <em>what matters</em>, develop interventions, explore assessment instruments, create policy, provide resources, and support care that aligns with <em>what matters</em> to this growing resource-intensive population.</p> <p><em>Keywords:</em> older adults, <em>what matters,</em> emergency department, adverse functional outcomes, identification of Seniors at risk, geriatric assessment</p>

Name thesis:degree_name

PhD Nursing

Level thesis:degree_level

Dissertation: USD Users Only

Discipline thesis:degree_discipline

Nursing

Year dc:date.available

2025

Author dc:creator

• Williams, Julie L

• Older Adults
• What Matters
• Emergency Medicine
• Functional Decline
• Geriatric Nursing

Repository record dc:identifier

https://digital.sandiego.edu/dissertations/1052

OAI identifier oai:identifier

oai:digital.sandiego.edu:dissertations-2063