--- url: 'https://www.healthinaging.org/geriatrics-friendly-emergency-care' title: 'Geriatrics-Friendly Emergency Care' author: name: 'Aimee Cegelka' url: 'https://www.healthinaging.org/user/99' date: '2019-08-14T14:36:38+00:00' updated: '2026-10-29T21:13:39+00:00' type: page summary: 'One of the places where older adults may receive health care is the emergency department (ED) at a hospital. ED visits can be confusing and intimidating for anyone. This is especially true for older adults and caregivers. Fortunately, some EDs are changing and getting more “geriatrics-friendly.”' tags: - Health published: true --- ## [Geriatrics-Friendly Emergency Care](/geriatrics-friendly-emergency-care) Older adults may need to visit an emergency department (ED) at a hospital. The ED can be loud, busy, and confusing. This can be stressful for older adults and their caregivers. Some hospitals are now changing their EDs to be more "geriatrics-friendly." This means the ED is safer and works better for older adults. ## Characteristics of a geriatrics-friendly ED ### Training in the Care of Older Adults EDs treat patients of all ages. But our bodies change as we get older, and health care needs to change too. Geriatrics-friendly EDs have staff who are trained to care for older adults. These staff members may be nurses, case managers, or social workers. They help doctors talk with patients, caregivers, and other health care providers. Trained staff know how to screen for problems that are common in older adults. During a check-up, they may ask questions about: - The ability to care for yourself at home - The ability to think clearly and stay focused - The ability to walk a short distance - Social needs that could affect recovery, such as how often you are visited by family or friends These questions also look for "red flag" warning signs. These include a sudden drop in how well you function, sudden confusion, or trouble walking or keeping your balance. Older adults with these warning signs will get more evaluation and care. Catching these problems early is often key to a faster and safer recovery. ### A Geriatrics-Friendly Environment An ED visit can take many hours. You may have to wait a long time before getting a hospital bed. Geriatrics-friendly EDs check on older patients often. This can lower the risk of confusion or other problems. **Delirium is a serious state of mental confusion.** It is important that the ED keeps older adults warm, fed, comfortable, and able to move around when possible. Older adults should not be left alone for long periods. Ignoring these needs can raise the risk of delirium. ED staff can help get needed medicines and food. They may move older adults to a quieter room if wait times are long. The goal is to treat older adults with dignity and make the visit less stressful. Many geriatrics-friendly EDs have special equipment to make visits more comfortable. These include: - Bedside portable commodes (toilets) - Reclining exam chairs - Warming blankets - Devices to help people hear better - Walkers and other mobility aids to help with safe standing and walking These tools help older adults during their visit and while waiting to go home or move to a hospital room. Seating for a family caregiver should also be easy to find. ### Attention to Medications As we age, our bodies process medicines differently. This raises the chance of side effects. Older adults often take more medicines than younger people. This also raises the chance of harmful reactions between different medicines. Geriatrics-friendly EDs pay close attention to the medicines older adults are taking. They may use these tools: - **Medication reconciliation:** This is the process of making the most complete and accurate list of all medicines a person is taking (including prescription and over-the-counter medicines). That list is then compared with the person’s medical records. - **Full pharmacy review:** This creates a correct and complete list of the medicines a person should be taking every time they move from one health care setting to another (for example, from the ED to a hospital room to a rehabilitation facility). These steps lower the chance that older adults will receive the wrong medicines or wrong doses. After leaving the ED, watch for an updated medicine list called an "After Visit Summary." ### Attention to Your Personal Goals of Care Geriatrics-friendly EDs help older adults think about their personal "goals of care." This means health care staff will talk with you about your wishes and values. This helps you decide which treatments are right for you. One way to share your health care wishes is through a legal document called an [advance directive](/age-friendly-healthcare-you/care-what-matters-most/advance-directives). An advance directive explains what kind of care you want or do not want at the end of life. A geriatrics-friendly ED may have a plan to discuss and record your goals of care. This may include adding an advance directive to your medical records. You can help this process by telling ED staff your goals of care early in your visit. To be prepared before an emergency, older adults and caregivers should: - Keep a copy of their advance directive handy and bring it to any ED visit - Give a copy to their regular health care team to keep on file If you or someone you care for does not have an advance directive, talk with family and others about your goals of care now – before an emergency happens. A geriatrics-friendly ED will include these goals in all treatment decisions. Geriatrics-friendly EDs are also good at balancing treatments that try to cure an illness versus those that focus on managing symptoms. This is especially important for older adults with serious illnesses. Palliative care is a type of care that focuses on relieving pain and other symptoms. It can be part of a treatment plan. If you or someone you care for needs emergency care, ask if any ED staff are trained in palliative care. If not, ask if palliative care professionals are available in the ED, hospital, or through a referral. ### Attention to Care as You Move Into and Out of the ED Older adults may move through several different care settings between arriving at the ED and going home. For example, an older adult may come from a nursing facility, then move to the ED, then to an Intensive Care Unit (ICU), then to a hospital room, and then to a rehabilitation facility. Each move is called a "[care transition](/transitions-care)." With each move, a person gets care from different providers. There is a risk that important information gets lost or miscommunicated during these moves. A geriatrics-friendly ED should have a plan to coordinate care and make sure these transitions go smoothly. When an older person is ready to leave the ED, staff will work to make sure the next care setting is safe and prepared. Geriatrics-friendly EDs should also communicate with staff at nursing or residential facilities when their residents leave and return. After discharge, the ED may arrange: - Follow-up with the older adult’s primary care provider - Home nursing or therapy services - Safe alternatives to hospitalization, such as a Hospital at Home program or transfer to a rehabilitation or respite facility The dates and times of follow-up appointments will be listed on the "After Visit Summary." Getting this information early in the ED visit can give older adults and caregivers peace of mind. ### Support for Caregivers Caregivers (or care partners) play a very important role in supporting older adults before, during, and after an ED visit. During the visit, ED staff will work with caregivers to understand how they can best help. The ED should also have a way to contact caregivers and keep them informed and included in decisions about the older person’s care. *Last Reviewed and Updated:* **October 2026** *By:* [**AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers**](https://www.healthinaging.org/about-us/about-website/content-contributors-and-reviewers)