PhD defence Marleen Geertruida Antonia Maria van der Velde

Keywords: Older adults, Emergency care, Nonspecific complaints, Care pathway

"Acute care demands in older adults: predicting outcomes, evaluating quality and optimising care"

This dissertation investigates how acute care for older patients can be improved, with particular attention to older adults presenting with non-specific complaints (NSC). 

The results indicate that frailty (the reduced resilience to recover from illness or stress), together with social and demographic factors, influences the risk of hospitalisation. At the same time, it becomes clear that measuring frailty alone is insufficient to reliably predict adverse outcomes. 

Patient experiences are essential for providing good care. This dissertation shows that, in acute care, there are still few suitable instruments available to systematically capture these experiences, particularly for older patients. 

To improve care for older adults with NSC, a dedicated care pathway has therefore been developed. This pathway focuses not only on the complaints themselves but also considers the patient’s overall situation. Standard tests provide additional information. The care pathway offers better insight into the patient, leads to higher satisfaction, and represents a step towards more comprehensive and accurate diagnoses. 

In short, this dissertation demonstrates that high-quality acute care for older adults is only possible when the patient’s full context is taken into account. 

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