Emergency Department Boarding Likely to Get Worse

April 29, 2025

Experts are warning that boarding in the emergency department (ED) for an extended period due to no available inpatient beds will worsen as the number of people 65 and older in the United States who are living with dementia is expected to double in the coming decades. Hospital beds are often in short supply, causing patients to wait in the ED.

Boarding has a negative impact not only on the patient, but also their families or caregivers and healthcare professionals. The challenge of treating patients with dementia waiting in the ED are similar to those with some psychiatric disorders – the waiting for additional evaluation, admission or transfer can lead to more confusion and agitation. ISMIE offers a course, Psychiatric Patients: Boarding in the Emergency Department , that provides guidance on how to help manage these individuals.

One in six visits to emergency departments in 2022 that resulted in hospital admission had a wait of four or more hours, according to a recent data analysis. Fifty percent of patients who were boarded for any length of time were 65 and older. Increasing age is one of the biggest risk factors for developing dementia, especially for those over 65.

For more information, please contact the Risk Management Division by email.