An emergency department (ED) is potentially an inhospitable environment to treat older people. A recent NICE publication noted that medical and nursing staf in EDs had variable levels of expertise and knowledge of the medicine of old age and that this may explain some of the variation in outcomes for older patients. The medical model of care ofen applied in EDs may presume serious illness in an older patient and prioritise invasive treatments and investigations at the expense of a more holistic care approach.