^* Emergency department, hospitalists, primary care, geriatricians
^† Home health services, Meals on Wheels, transportation services, Alzheimer’s Association
^‡ Emergency department and geriatricians
^§ ED Administration Conference, Western ED Operations Conference

As summarized in the above table, each approach has advantages and disadvantages, but each awaits definitive proof-of-concept.⁷

The expansion of geriatric care in EDs will continue, and we as EM providers have the opportunity to either define best practices or have best practices defined for it by others.⁸ Delivering high-quality, patient-centric emergency care for an aging population will remain a challenge and will require a team-based approach. A one-size-fits-all solution to bridge disciplines and create comprehensive ED geriatric care is unlikely, so the best strategy is to link innovation and providers in a multipronged approach similar to that seen in the growth of cardiac, stroke, trauma, and pediatric care.

Dr. Melady is employed at Mount Sinai Hospital in Toronto. Follow him on Twitter at @geri_EM.

Dr. Lowthian is employed at Monash University in Melbourne, Australia. Follow her on Twitter at @Emergedu.

Dr. Carpenter is employed at Washington University in St. Louis. Follow him on Twitter at @GeriatricEDNews.

References

1. Lowthian JA, Curtis AJ, Cameron PA, et al. Systematic review of trends in emergency department attendances: an Australian perspective. Emerg Med J. 2011;28(5):373-377.
2. Hogan TM, Losman ED, Carpenter CR, et al. Development of geriatric competencies for emergency medicine residents using an expert consensus process. Acad Emerg Med. 2010;17(3):316-324.
3. Conroy S, Nickel CH, Jónsdóttir AB, et al. The development of a European curriculum in geriatric emergency medicine [published online ahead of print April 25, 2016]. Eur Geriatr Med. doi:10.1016/j.eurger.2016.03.011.
4. McClelland M, Sorrell JM. Enhancing care of older adults in the emergency department: old problems and new solutions. J Psychosoc Nurs Ment Health Serv. 2015;53(3):18-21.
5. Hwang U, Rosenberg MS, Dresden SM. Geriatrics Emergency Department – The GEDI WISE Program. In: Malone ML, Capezuti E, Palmer RM, eds. Geriatrics Models of Care: Bringing ‘Best Practice’ to an Aging America. Switzerland: Springer International Publishing; 2015:201-209.
6. Carpenter CR, Hwang U, Rosenberg M. New Guidelines Enhance Care Standards for Elderly Patients in the ED. ACEP Now. March 6, 2014.
7. Platts-Mills TF, Glickman SW. Measuring the value of a senior emergency department: making sense of health outcomes and health costs. Ann Emerg Med. 2014;63(5):525-527.
8. Hogan TM, Olade TO, Carpenter CR. A profile of acute care in an aging America: snowball sample identification and characterization of United States geriatric emergency departments in 2013. Acad Emerg Med. 2014;21(3):337-346.