Older adults often visit the emergency department (ED) with chief complaints that understate or detract from their true complex health care needs. These needs are frequently missed because addressing them requires a time-consuming effort that is antithetical to the (necessarily) rapid, complaint-specific protocols of the ED. Key ED performance indices (e.g., length of stay; through-put) also create a disincentive against undertaking comprehensive geriatric assessments when not clearly germane to the chief complaint. However, ignoring these complex care issues can contribute to poor health outcomes. These visits often serve as sentinel events in the patient's health trajectory which irreversibly hastens loss of independence. Such encounters will only increase as the population ages.
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