MacDonald Z, et al. - Researchers sought to determine adherence among emergency department (ED) patients to outpatient specialized geriatric services (SGS) following ED evaluation by the geriatric emergency management (GEM) nurse. In addition, they sought to recognize barriers and facilitators to attendance. In this prospective cohort study, performed at two academic EDs, 103/285 eligible patients (86 eligible but not enrolled, 86 declined specialized geriatric referrals, and 10 declined study participation) were enrolled; the mean age was 83.1 years, 59.2% were female, and 73.2% were cognitively impaired. Referrals were made to Geriatric Day Hospital programs (50.5%), geriatric outreach (26.2%), falls clinic (12.6%), and geriatric psychiatry (8.7%). They identified that adherence with follow-up was 59.2% indicating suboptimal adherence among older ED patients referred by the GEM team to SGS, and there was a large proportion of patients who declined these referrals in the ED. The identified barriers to attendance were patients did not feel SGS were needed (52.1%), inability to recall GEM consultation (53.4%), and dependence on family for transportation (72.6%). The highest adherence (81.5%) was observed with home-based assessments.