Internal and Emergency Medicine

, Volume 2, Issue 4, pp 292–301 | Cite as

The elderly in the emergency department: a critical review of problems and solutions

  • F. SalviEmail author
  • V. Morichi
  • A. Grilli
  • R. Giorgi
  • G. De Tommaso
  • P. Dessì-Fulgheri


The elderly are an ever increasing population in overcrowded emergency departments (EDs) in many countries. They have multiple health problems and consume more time and resources than younger patients. They are more frequently admitted and experience adverse outcomes after they are discharged from the ED. These frail patients could require specific skills, instruments and organisational models of emergency care in order to look after their complex needs. As such, several approaches have been tried and tested to improve emergency care for them. This article analyses the epidemiological load and problems faced when confronted with elder ED patients. We critically review organisational models, clinical approaches and methodologies in order to reduce ED physicians’ difficulties and to improve quality of care and outcomes for elder patients. Triage, clinical assessment and discharge are identified as critical moments during an emergency care process, and interesting and useful instruments are proposed as possible solutions.


Aged Emergency department Appropriateness Geriatric assessment Quality of care 


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Copyright information

© Springer-Verlag Italia Srl 2007

Authors and Affiliations

  • F. Salvi
    • 1
    • 3
    Email author
  • V. Morichi
    • 1
  • A. Grilli
    • 1
  • R. Giorgi
    • 2
  • G. De Tommaso
    • 2
  • P. Dessì-Fulgheri
    • 1
  1. 1.Department of Internal MedicineUniversity “Politecnica delle Marche”AnconaItaly
  2. 2.Geriatric Emergency ServiceItalian National Institute for Research and Care on Aging (INRCA)AnconaItaly
  3. 3.Clinica di Medicina InternaAzienda Ospedali RiunitiAnconaItaly

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