Abstract
AIM: To review primary research reporting the inclusion of informal carers in caring for older people in the emergency department. DESIGN: An integrative review employing Whittemore and Knafl's updated integrative review methodology. METHODS: A systematic search was undertaken between November 2023 and September 2024. Ten articles met the inclusion criteria of primary research reporting the inclusion of carers in the care of older adults in the emergency department. Exclusion criteria included studies conducted outside of the emergency department, not carer-related, and those not restricted to carers of older adults. The Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the articles. DATA SOURCES: Medline @ Ovid, EBSCO, Wiley Online Library, Cochrane, EMBASE and SCOPUS. RESULTS: Thematic analysis produced two reoccurring themes: Carers as advocates and Carers as outsiders. Through sharing of information and support of the older adult, carers can act as advocates. Restrictive admission policies, exclusion from decision-making processes, and failure to be heard by the healthcare professional resulted in carers feeling like outsiders. CONCLUSION: Including carers is essential to support the care of vulnerable older adults in the emergency department. Care partnerships between healthcare professionals and carers can be enhanced with education on effective and respectful communication processes and support of carer well-being. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This review highlights the essential nature of care partnerships involving informal carers in the emergency department for providing high-quality care to older adults with complex care needs. An appropriate carer inclusion programme could support emergency department clinicians, carers and older adults. REPORTING METHOD: The PRISMA 2020 checklist was used to ensure adherence to review processes. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.