Call to Action: Improving the Care of Older Patients in Emergency Departments. A much-needed Collaboration between Emergency Medicine Physicians and Geriatricians.

Adults aged greater than 65 have the highest Emergency Department (ED) use rates in the United States and worldwide¹. This population often suffers from multiple co-morbid diseases and has a high incidence of polypharmacy, mobility disorders, and cognitive impairment². Many of these older adults also have poor social support and utilize the ED as their primary source of health care delivery³. Repetitive ER visits and frequent hospitalizations in medically complex older adults often results in a decline in cognitive and functional status⁵. Furthermore, the fluctuating course of the COVID-19 pandemic has uniformly stressed our ED’s capacity to function and with limited resources, dramatically amplified the challenges of caring for older adults to an all-time high⁵. Resources are needed to identify, assess, follow and transition high-risk older adults to an appropriate level of care in high acuity and high volume EDs. However, this task is very challenging, and it leaves our Emergency Medicine colleagues with a binary choice: to admit or discharge. This process often results in hospitalizations, which contribute to the vicious cycle of unaddressed geriatric syndromes⁴. How then, as geriatricians, can we better support our ED colleagues as they continue the remarkable work of caring for this group of patients?