News

Older adults make up a growing share of 9-1-1 EMS calls — and this population differs substantially from younger adults due to physiologic changes, cognitive impairment and behavioral disturbance, atypical presentation of disease, frailty, functional limitations, the impact of comorbid conditions, and the effects of polypharmacy. Not considering these when providing prehospital care is common and may lead to substantial harm for older adult patients. I was excited to contribute to an...

I was delighted to present at #ACEP2025 on work led by colleague Michael Alfonzo highlighting that older adults board in the ED after hospital admission longer than younger adults. This is important to acknowledge and address given that older adults may be at particularly high risk for poor outcomes from prolonged boarding. It has been great to focus on this...

Primary care providers, who care for older adults in outpatient clinics are on the frontlines of elder mistreatment detection. A primary care visit may be the only time that a mistreated older adult ever leaves their home environment, making this encounter an essential opportunity to identify mistreatment and initiate intervention. Though I'm an ED physician, I was excited to be interviewed, along with amazing Weill Cornell Medicine ...

The SIRENS project (Screening and Intervention to Reduce Elder Neglect Study) is focused on developing and assessing the impact of a novel primary care screening tool to identify elder neglect in patients with dementia and a point-of-care technology-driven intervention for caregivers. It was great to present recently with colleagues Mark Lachs and Sara Czaja at the...

Great work to Rana Barghout and Josh Lachs on our recent work published in SAEM Pulse! The "sliding scale of capacity" is a really under-appreciated topic in clinical ethics. In the most recent edition, we co-authored “Balancing Risk and Autonomy: Applying the Sliding Scale of Capacity in AMA Decisions,” where we discuss how emergency physicians can approach AMA situations by...

According to a recent NEJM Group / New England Journal of Medicine article co-authored by colleague, collaborator (and courtesy research faculty member within our Weill Cornell Medicine Department of Emergency Medicine!) Kristin Lees Haggerty as well as geriatrics leader David Reuben: "Health...

Thanks again to everyone who contributed to and participated in our department's recently held 3rd Annual Weill Cornell Medicine Emergency Medicine Research Symposium. I really enjoyed (and learned an enormous amount) moderating a panel discussion including Emergency Medicine research leaders from other institutions in our region: Bernard P. Chang from Columbia University,...

Excited to be invited by the U.S. Department of Justice to discuss our work on the Vulnerable Elder Protection Team at Weill Cornell Medicine in a webinar hosted by the Elder Justice Initiative and OVC's Training and Technical Assistance Center. More than 500 folks registered -- it was great to see so much interest (in urban and rural settings) about ED/hospital-based elder...

This is National Crime Victims’ Rights Week (ovc.ojp.gov/ncvrw2025), which recognizes the accomplishments of the crime victims' movement. The theme for 2025 is kinship, highlighting that shared humanity should be at the center of supporting all survivors and victims of crime. Thanks to all organizations and professionals dedicated to building connections, standing up for survivors, and...

Prolonged Emergency Department boarding after hospital admission is very common and is linked to patient harm. Evidence suggests that older patients are at increased risk of complications from boarding, including the development of delirium and deconditioning. By prioritizing the admission of at-risk older patients to inpatient beds, ED may improve the both the quality of care for these patients and reduce inpatient lengths of stay. Older patients who must board in the ED may benefit...

Many healthcare workers – even those who work primarily in a hospital setting – are not familiar with the complex payment systems for long term care, home-based care and post-acute rehabilitation for older adults in the US. Understanding this is essential for medical decision-making inside and outside the hospital and to help patients and families navigate Medicaid, long term care insurance, and Medicare. I was excited to give a presentation to medical students at ...

For many older adult patients receiving care in the Emergency Department (ED), unmet social needs and social drivers of health contribute to their presentation as well as to morbidity and mortality. The ED can serve as an important opportunity to identify and intervene on these social needs. Christina Shenvi, MD, PhD, MBA, FACEPm, Elaine Gottesman, and I collaborated on chapter that highlights this in an...

Shifting the focus in elder mistreatment research and practice to individual sub-types may provide improved approaches to screening and ultimately to intervention. In a recently published article, we try to demonstrate this – using the example of caregiver neglect, the subtype associated with highest mortality. We describe a process to develop caregiver neglect screening and intervention programs and to measure their effectiveness and impact in a manuscript recently published in...

Older Veterans may be at particularly high risk for experiencing elder abuse and neglect. I was excited to present about improving elder mistreatment identification and management at the monthly VHA Geriatric Emergency Department Community of Practice meeting. Thanks to my fellow presenters: Luna Ragsdale MD from the DURHAM VAMC, Colleen McQuown MD FACEP and Dyan...

Access of older adults, particularly those with dementia, to firearms is a public health concern we don't talk about -- so I was very glad earlier this month to have the opportunity to present with David Hoffman, JD, FCPP as part of Drexel University's Thomas R. Kline School of Law Vital Signs (Conversations about Healthcare and the Law) series. Thanks to Professor Elizabeth Kukura for inviting us and to the participants for the great questions asked. Also, thanks to Emmy Betz MD MPH, Joseph...

Great to see so many colleagues and friends from #Emergency Medicine at #Clin-STAR2024 and #Beeson2024 last week -- always really wonderful meetings, and I really appreciate the Geriatric EM community -- amazing to catch up with folks, hear about the extraordinary work...

The ED and hospital are a critical but under-utilized opportunity to detect elder mistreatment and initiate response. Really enjoyed participating with colleagues in a ground-breaking meeting hosted by the Texas Elder Abuse & Mistreatment (TEAM) Institute at The University of Texas Health Science Center at Houston (UTHealth Houston). At the meeting, pioneer Carmel Dyer was posthumously recognized for her extraordinary impact on the field and...

Attending #ACEP24 last week reminded me how important conferences can be -- to see and re-connect with colleagues and friends from around the world, to hear about exciting innovative work that is changing the practice of emergency medicine, and to re-energize about why we all do this unique job -- this year, our Weill Cornell contingent included several medical and pre-medical students (who did a super job...

I was excited to participate earlier this week in the Nebraska Hospital Association's Vulnerable Populations Conference -- presenting with colleagues and friends Kristin Lees Haggerty, Rebecca Stoeckle, and Olanike Ojelabi of edc.org about elder mistreatment. Older...

As part of the UN Decade of Healthy Ageing efforts, the WHO recently released a database of promising interventions to prevent and respond to the abuse of older people. The database can be found here. It represents the first step in the...

I was pleased to contribute to an article led by Elizabeth Bloemen, MD, MPH and recently published in the Journal of Elder Abuse and Neglect that explores the complex, nuanced ethical issues that arise in providing ED/hospital care for older adults experiencing elder mistreatment -- and suggests approaches to address them. This article was a collaborative effort between the elder abuse response teams and...

I was excited to contribute last Friday to the really great Interdisciplinary Palliative Care Conference 2024 focused on Great presentations by and insights from leaders including Anne Mosenthal, Susan Cohen, Cherisse Berry, MD, FACS, ...