The Experience of Frail Older Patients in the Boarding Area in the Emergency Department: A Qualitative Systematic Review

Abstract

Background/Objectives: Boarding refers to the period when patients deemed stable in the emergency department (ED) are temporarily monitored, wait to be admitted, and receive appropriate care. As life expectancy increases, so does the importance of understanding the dynamics and experiences of older adults with frailty in emergency settings. The absence of a care environment tailored to specific needs could diminish the overall quality of care provided, threatening the health and well-being of this population. To our knowledge, how frail older adults experience this has not yet been synthesized in a qualitative systematic review. The aim of this study was to explore the lived experiences of frail older adults during the emergency department (ED) boarding phase Methods: This systematic review was conducted using PubMed, OVID, and Scopus in October 2024. No time restrictions were settled and only articles published in English were included. Following the predefined inclusion criteria, two researchers independently extracted and synthesized the data using the Joanna Briggs Institute (JBI) meta-aggregation methodology and instruments. Results: Seven studies were included. Thirty-one findings were identified and grouped into seven categories and three themes regarding the lived experiences of frail people in ED boarding areas. The themes we identified were discomfort, distress, frustration, the experience of positive/negative attitudes of healthcare providers, and the supportive role of family members during ED LOS (length of stay). Conclusions: Older frail adults experience significant physical and psychological distress during ED boarding. It is necessary to manage their specific needs through targeted actions aimed at improving their overall experience and quality of care in emergency settings.