The following manuscript is an Editorial to accompany this published JGEM Review Article.

In the JGEM article linked above, Gerson et al¹ describe the history and journey of geriatric emergency medicine to the present day. As they clearly illustrate, today’s champions of improved emergency care for older adults are standing on the shoulders of giants who over the last several decades have demonstrated that older adults needing emergency care are at risk for adverse health outcomes. They use emergency services at higher rates and require more resources.² These initial studies that revealed the complexity of caring for older adults in the ED, founded the field of geriatric emergency medicine to catalyze research and education to refine the care of older adults in the Emergency Department.

Sadly, the COVID pandemic has only made it clearer that despite the amazing heroes who work in emergency departments around the globe, the physical structures and care processes of emergency departments are poorly matched to the needs of many vulnerable older adults. The challenges to improve the care of older adults with multimorbidity with complex medical and psychosocial concerns in fast-paced and chaotic emergency department remains. Table 1 below highlights the challenges of older adults who receive care in the emergency department. Fortunately, due to the efforts of many for decades, we may be at an inflection point of substantial and sustainable improved emergency care for older adults.