To the Editor: With Australia’s rapidly ageing population and an explosion in the number of retirement villages and nursing homes, Finn and associates are to be congratulated for ventilating the subject of the interface between residential aged care facilities and emergency departments.1

My experience of emergency department (ED) and aged care facility relations spans over 50 years and I have been involved in both sides of the equation. Firstly as a surgeon, then as director of an ED, and finally, as a resident of a retirement village for over 20 years (including, for my wife, 5 years in the affiliated nursing home), and during that time my wife and I have had at least eight episodes as patients in an ED.

Retirement villages and nursing homes are not equipped or organised to handle medical or surgical emergencies. Problems of “disposal” arise after ED assessment and treatment in a public hospital. The hospital may not have an empty bed. The patient’s condition may not be serious enough to require a hospital bed, but the patient may not be well enough to return to his or her retirement village. Privately insured patients may have the option of transferring to a private hospital but usually spend an unnecessarily long time in the ED awaiting such transfer.

Matters that need attention are:

• a standing arrangement between public and neighbouring private hospitals to facilitate quick transfer of suitable patients.

• the removal of long delays in EDs that occur while waiting for the results of investigations and even longer periods awaiting “higher opinions” after receiving these results.

• a speedier and more detailed hospital summary addressed to the general practitioner (if known) as well as to the aged care facility concerned.