How Paramedics Can Make a Difference in Geriatric Care

With Megan Corry

Community paramedicine originated in rural settings to address challenges in accessing care and expanded to urban settings, where it has the potential to reduce ED readmission rates of older patients. Paramedics are uniquely positioned to observe and assess patients in their homes, providing critical insights into determinants of health outcomes such as environment, social network, mobility, and cognitive impairment that can inform care plans.

In this episode of GEMCast Dr. Christina Shenvi is joined by Megan Corry, the Director of the Paramedic Program at the City College of San Francisco. Megan helped develop a geriatric specialty rotation for paramedics at the initial training level that focuses on a biopsychosocial approach to patient assessment. Learn about the history of community paramedicine, the potential impact of geriatric specialty paramedicine, and key assessments and communication strategies they are implementing to improve the care of older adults.

Key Points

  • Key areas of geriatric care that paramedics learn:
    • 4Ms: what Matters, Medication, Mentation, Mobility
    • Communicating with older patients
    • Differentiating dementia and delirium
    • Social Determinants of Health – e.g. not able to pay bills.
    • Tools to assess mobility
    • Assessing the home
  • How can paramedics use these skills in the future
    • On their ambulance runs
    • As a community paramedic
    • Home visits/evals for older patients
    • Prevention
  • Where is the field going and what opportunities are there?
    • Multidisciplinary approach
    • Need data to assess the return on investment in terms of cost savings, readmission rates, and patient health.

Assessment Tools

  • Delirium Triage Screen
  • Richmond Agitation and Sedation Scale
  • Confusion/Agitation in the Elderly (ADEPT)
  • Timed Up & Go (TUG)

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