Can an Emergency Department Adequately Address an Older Adult who has Complex Needs?

he Emergency Department (ED) is a critical component of the geriatric continuum of care. Older adults comprise up to 25% of ED attendance and 38% of patients transported by emergency medical services (EMS.)2-4 Despite this, the traditional rapid linear ED treatment framework remains illequipped to meet the complex care needs of many vulnerable older adults.5-8 Upon discharge, the ED-to-home transition is a high-risk time for older adults. About one third of older adults will suffer an adverse result including ED revisit, eventual hospital referral, admission to a long-term care institution, or death within 3 months of the ED visit.9 Moreover, extended or frequent ED visits and repeated hospitalizations are costly. It has been reported that the cost of two potentially preventable geriatric syndromes, hospital delirium and repeated falls, is projected to be $83 billion a year in the United States.10,11