University of Hertfordshire

From the same journal

By the same authors


  • Marina Buswell
  • Philip Lumbard
  • Larissa Prothero
  • Caroline Lee
  • Steven Martin
  • Jane Fleming
  • Claire Goodman
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Original languageEnglish
Pages (from-to)61-70
Number of pages10
JournalEuropean Journal of Emergency Medicine
Publication statusPublished - 2 Dec 2014


OBJECTIVE: To synthesise the existing literature on the roles that emergency medical services (EMS) play in unplanned, urgent and emergency care for older people with dementia (OPWD), to define these roles, understand the strength of current research and to identify where the focus of future research should lie.

DESIGN: An integrative review of the synthesised reports, briefings, professional recommendations and evidence. English-language articles were included if they made any reference to the role of EMS in the urgent or emergency care of OPWD. Preparatory scoping and qualitative work with frontline ambulance and primary care staff and carers of OPWD informed our review question and subsequent synthesis.

RESULTS: Seventeen literature sources were included. Over half were from the grey literature. There was no research that directly addressed the review question. There was evidence in reports, briefings and professional recommendations of EMS addressing some of the issues they face in caring for OPWD. Three roles of EMS could be drawn out of the literature: emergency transport, assess and manage and a 'last resort' or safety net role.

CONCLUSIONS: The use of EMS by OPWD is not well understood, although the literature reviewed demonstrated a concern for this group and awareness that services are not optimum. Research in dementia care should consider the role that EMS plays, particularly if considering crises, urgent care responses and transitions between care settings. EMS research into new ways of working, training or extended paramedical roles should consider specific needs and challenges of responding to people with dementia.


This is the accepted manuscript for the following article: Marina Buswell, et al., “Unplanned, urgent and emergency care: what are the roles EMS provide for older people with dementia? An integrative review of policy, professional recommendations and evidence”, European Journal of Emergency Medicine, Vol. 33(1), December 2014. The final published version is available at: © 2014  BMJ Publishing Group Limited. 

ID: 10220565