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With this issue, CJEM devotes an entire section to research in the field of geriatric emergency medicine (EM), that subspecialty of EM that focuses on the needs of older patients and the opportunities for providing optimal care to them. I salute the editors for devoting this much space to work by researchers in an area that some practitioners still don’t even identify as “a thing”; while those of us identify it as “the thing that is going to have the largest impact on the practice of EM for the next 30 years.” Even 10 years ago, focus on the care of older emergency department (ED) patients seemed like a niche interest. Ten years later, demographic realities have made the importance of that focus clear to anyone working in an ED. It is not necessary to review tedious demographic statistics. One look at any street or shopping mall or doctor’s waiting room in the Western world reveals that the shape and structure of society are changing. The population pyramid has been inverted, and, for the next several decades, there will be increasingly more people over age 65 than under age 30 in most societies in the world. Those people will be the main consumers of ED care. EM has always prided itself on its ability to respond to urgent social realities (AIDS, severe acute respiratory syndrome [SARS], gun violence, the opioid epidemic, etc.). As the policy statement from the International Federation of Emergency Medicine points out, the field of EM must embrace the reality that older people are among our core users and that their care needs are among our raisons d’être. Now is the time for EM to champion a system change to ensure optimal care to older patients – and to provide the research that supports and drives that change. In 2013, a consensus group of emergency physicians, nurses, and geriatricians published the Geriatric ED Guidelines. Those guidelines outline opportunities for improvement that can be implemented in any general ED, related to the following: ∙ Staffing – the addition of nurse-led geriatric case management and interdisciplinary teams to provide additional assessments ∙ Education – the addition of continuing professional development to enhance skills knowledge and attitudes about geriatric issues and their impact on ED care ∙ Processes of care – the addition of standardized protocols and procedures around screening, investigation, and management of conditions and presentations (from hip fractures to functional decline to frailty to unmet social needs) that are often present in older patients ∙ Transitions of care – the addition of strategies to integrate ED care with the continuum of the patient’s care (recognizing that the ED is not just the front door to the hospital but also a “front porch” before a return to the community) ∙ Physical environment of the ED – the addition of features that extend from a thorough re-build using senior-friendly features to ensuring the presence of the most basic features essential to caring for vulnerable older people (the presence of canes, walkers, warm blankets, and food!)

Geriatric emergency medicine: Research priorities to respond to “The Silver Boom”