Navigating Emergency Care: Understanding Older Adults' Experiences at the Kingston Health Sciences Centre

Objectives: Older adults (65+) in Ontario have the highest emergency department (ED) visit rates, yet often face delayed care and unmet healthcare needs. This study investigates how older adults perceive and navigate their ED care experiences at the Kingston Health Sciences Centre (KHSC), compared to younger adults and identifies factors driving their positive and negative care experiences. Methods: A secondary mixed-methods analysis was conducted using cross-sectional data on ED care experiences at the KHSC. Qualitative data included anonymously recorded micronarratives describing participants' ED experiences. Quantitative data included patients' numerical interpretations of their shared experiences through sensemaking triad questions. Quantitative descriptive analyses examined contextual differences between older (>65) and younger (≤65) adults, while a qualitative abductive thematic analysis focused on older adults' narratives. Results: A total of 1,116 participants were included, with 214 older adults. Older adults reported significantly higher rates of physical (19.2% vs. 10.0%) and sensory (5.1% vs. 1.6%) disabilities than younger adults, and more positive emotions during their ED visit (55.6% vs. 48.6%, p < 0.01). Thematic analysis of 201 first-person micronarratives revealed four themes: Communication and Information About Care; Respectful and Compassionate Interactions with Staff; Waiting and Flow of ED care; and Physical Comfort and Support During the ED Visit. Older adults emphasized the need for clearer communication and felt powerless in comparison to younger patients. Conclusions: In the ED, older adults valued attentive staff and clear communication but described disempowerment when these were lacking. Recommendations include adopting an age-friendly ED framework and improving provider communication training.