When the Emergency Room Isn’t the Best Option: A Safer Path for Older Adults

Nurse or doctor give man support during recovery or loss. Caregiver holding hand of her sad senior patient and showing kindness while doing a checkup at a retirement, old age home or hospital

The Problem: Older Adults Are Spending Too Much Time in the ER

For many older adults, a visit to the emergency department (ED) can do more harm than good. The loud noises, bright lights, long waits, and unfamiliar faces create the perfect storm for delirium, confusion, and a rapid decline in function.

A new analysis published in JAMA reveals that more than 1 in 5 older adults now experience ED stays longer than 8 hours with a number that has sharply increased over the past decade (Hunt, 2025). Even more troubling, over one-third of older adults are now boarded in the ED as they are waiting for an inpatient bed for more than 3 hours, a threshold known to increase mortality risk (Haimovich et al., 2025).

These trends aren’t just concerning. They’re dangerous. And for families and hospitals alike, they raise an urgent question: Is there a better way to care for aging adults before and after the emergency room?

The Better Way: Care That Starts at Home

At TheKey, we believe that many emergency visits can be avoided entirely. When they do happen, we can help ensure a safer, faster transition home.
As the nation’s leader in private home care for older adults, we offer a better alternative:

Rapid, in-home support after hospital or ED discharge
24/7 caregiver coverage, including dementia-trained teams
Help with medication reminders, hydration, mobility, and daily routines
A calm, structured environment that reduces the risk of delirium and rehospitalization.

We support hospitals, discharge planners, and care teams by:

helping older adults stabilize at home after a discharge
providing in-home care and support that can reduce the likelihood of unnecessary return visits to the ED
supporting continuity of care in those especially important 30 days after discharge

Whether you’re a family caregiver trying to keep a loved one safe, or a healthcare provider working to improve outcomes and meet CMS Age-Friendly standards, TheKey is here to help.

Why ED Visits Are So Risky for Older Adults

The JAMA study points to several reasons why emergency departments are especially hazardous for aging adults:

Disrupted sleep and immobility can trigger delirium—a sudden change in thinking, attention, and awareness
Overstimulation and noise in the ED environment worsen confusion, especially in those with cognitive impairment
Long boarding times increase risk for pressure injuries, infections, and falls
Hospital bed shortages mean delayed admissions and unsafe discharges at night
(Hunt, 2025; Kennedy et al., 2025)

For individuals living with dementia, even short ED stays can lead to lasting declines in function.

Our Solution: Proactive, Personalized Home Care

At TheKey, we’ve built a model that aligns with the goals of Age-Friendly Health Systems and leading geriatricians nationwide.

Here’s what sets us apart:

Rapid Response After ED or Hospital Discharge. We help families and hospitals stabilize older adults in the home within 24–48 hours of discharge.
Delirium Risk Reduction. Our Balanced Care Method^® supports consistent routines, nutrition, hydration, sleep, and cognitive engagement—all proven to reduce delirium risk.
Emergency Diversion Program. Our care teams are trained to identify early warning signs (things like confusion, infection, or mobility issues) so we can prevent avoidable ED visits.
Dementia-Informed, 24/7 Support. We specialize in care for individuals with cognitive change, providing calm, trusted care partners trained in redirection and therapeutic communication.

For Hospitals and Referral Partners

TheKey is proud to support discharge planners, geriatric ED programs, and senior living communities as a trusted post-acute partner. TheKey can help:

Reduce 30-day readmissions
Decrease ED recidivism
Improve CMS compliance for Age-Friendly Hospital metrics
Enhance patient and family satisfaction

We welcome collaboration with emergency departments, transitional care teams, and hospital-at-home programs.

Take the Next Step

If you’re a family member caring for a loved one or a provider looking to avoid unnecessary ED visits, we’re here to help. Contact us or call TheKey today to speak with a care expert at (866) 425-2180.

Shadi Gholizadeh, PhD, MPH, MSc, CMC

Shadi Gholizadeh, PhD, MPH, is Senior Vice President of Clinical Excellence and Quality at TheKey. A licensed clinical psychologist, Dr. Gholizadeh leads TheKey’s enterprise-wide efforts to elevate quality, advance clinical strategy, and support both family and professional caregivers through training, programming, and research-informed guidance. She brings a rich background in behavioral medicine and public health, with clinical expertise in aging in place, dementia care, and helping individuals and families adapt to the challenges of chronic illness with dignity and compassion.

Dr. Gholizadeh received her undergraduate degree in psychology from Stanford University, and completed graduate training at the London School of Economics and UC San Diego. In addition to her work at TheKey, she serves as Clinical Assistant Professor at UCLA, where she supervises doctoral students in psychological assessment. She also maintains a small private practice supporting high-achieving professionals who are navigating the complexities of midlife, including caring for aging parents while raising children—the so-called "sandwich generation."