An Audit of Referrals to Occupational Therapy for Older Adults attending an Accident and Emergency Department

The greater number of older people in communities is reflected in their increasing demands on the services of accident and emergency (A&E) departments. Recognition of the complex needs of older adults attending A&E departments has resulted in many National Health Service trusts employing occupational therapists in these departments. The occupational therapists are required to assess and evaluate a patient's functional status and, using a team approach, to make decisions about his or her wider needs, including therapeutic requirements and social provision.

In order to audit the provision of the occupational therapy service in an A&E department, data were collected monthly over a 3-year period in a single district general hospital on the referrals made by medical and nursing staff. The mean age of the patients referred was 80 years. The majority of the patients were female and living alone. The most common presenting problem was that of a fall, with a resulting fracture in half of the patients. The occupational therapy input in the A&E department was demonstrated in this study to save admissions to acute hospital care, amounting to an equivalent of two beds saved in each of the years covered by the audit.