Description/Overview: Background: World-wide older adults are every increasingly frequent users of Emergency Department (ED) services. Unlike younger, more customary users who present for care with emergent problems, such as accidents, that have relatively clear solutions, frequently older adults present with obscure problems that have neither obvious nor quick solutions. While information is available about the medical diagnoses associated with their visits, less is known about the influence of geriatric syndromes and chronic co-morbidities on elders’ ED use. These latter factors have important implications for the role of ED nurses who work at the intersection of the ED care model and geriatric nursing. Purpose: To describe, from a cross-national perspective, profiles of older ED users, the perspective of nurses about their roles, and the implications of these for changes in the ED nursing model. Methods: Papers will describe the profiles of ED users in the U.S. and Australia and the voices of nurses about working in the intersection of ED and geriatric care. Results: Papers show the mismatch between the current ED care model and the needs of many older ED users. Discussion will focus on the implications of these findings for the practice of ED nursing in the twenty-first century. Conclusions: Clearly understanding what brings older adults to the ED is the first step in tailoring nursing care to meet their needs. The need for new practice models that support culture change and gerontological innovation within the ED and the elements required in these new models will be emphasized.

Learner Objective #1: Describe current trends in Emergency Department (ED) use among older adults in hospitals in the U.S. and Australia and implications for the ED care model.

Learner Objective #2: Based on the perspectives of nurses and data, describe culture and practice changes needed to improve care at the intersection of ED and geriatric nursing.