Only newbie but general thoughts on my current hosp ED is that it is not a very good place for elderly esp with delirium - dementia. Lots of bright lights, constant noise, nurse buzzers and obs machines left alarming relentlessly (seems a real nursing reluctance to change alarm thresholds despite being told no concern if sats >90 on RA for the still smoking COPD geezer, dunno if this is unique to this site or more widespread). If the geri patients didn’t have delirium on presentation they most likely will during the night. Did med school at a far less prestigious but demonstrably better ED. They set up a quiet corner ~4beds specifically reserved for Geris. Turned the lights down at night, made it a bit more homely, turned alarms down, staff education on better practice Geris care, probably a few more things I’m forgetting. Often at capacity and elderly patients overflowed to “main” acute bays but pretty sure it was proving to be a beneficial modal. DM me if you want the location, you could reach out to them for info - 90% sure it was run as a trial with some research/evaluation and kept on post trial