OCTOBER 18 -- You've just brought your elderly mother to a crowded Emergency Department.
After hours of waiting and a brief consultation, you are told she does not need to be admitted and is discharged with medication.
She will be followed up at the community clinic. You leave relieved but uncertain -- is that really all the help available for her recovery at home?
This scenario is common for many Malaysian families caring for ageing parents.
While Emergency Departments are the front line of care adults, what happens after discharge often determines whether they recover well or end up back in the hospital.
In healthcare, this crucial process is called "transitional care" -- a coordinated effort to ensure patients receive continuous and consistent care as they move between hospitals, clinics or home.
According to the American Geriatrics Society, it involves more than just a discharge note; it includes a personalised care plan, family education and coordination among doctors, nurses, and community health providers.
However, Malaysia's hospital-centred system struggles to deliver this level of coordinated care.
Emergency departments are busy on the immediate medical issues like infections or injuries.
Yet for many older adults, these acute problems stem from deeper issues such as frailty, dementia, or poor mobility -- conditions that require holistic assessment and follow-up, not just treatment of the immediate illness.
A "geriatric-friendly emergency department" would include a "Comprehensive Geriatric Assessment (CGA)" -- a structured review of an older person's medical conditions, physical, psychological health and social support.
Instead of focusing on one problem, CGA looks at the whole person, aiming to improve quality of life and maintain independence. Based on the findings, healthcare providers can coordinate with physiotherapists, dietitians, pharmacists or social workers to support the patient after discharge.
Some Malaysian hospitals, particularly in urban centres like Kuala Lumpur are beginning to integrate such practices.
There are also pilot programmes such as "virtual wards," where older patients receive monitoring and follow-up at home via teleconsultation.
Yet these services remain limited and uneven across the country. Many emergency departments still lack structured geriatric assessments or dedicated transition pathways due to constraints in human resource and expertise.
Neighbouring Singapore offers a model worth considering. Its Agency for Integrated Care (AIC) acts as a central hub connecting hospitals, community clinics, and care providers to deliver seamless, person-centred care for older adults.
Through AIC, seniors can access home nursing, rehabilitation, and financial support through a single system -- ensuring no one is left behind after hospital discharge.
Malaysia, projected to become an "aged nation by 2030", urgently needs a similar integrated approach.
Strengthening transitional care is not a luxury -- it's a necessity to prevent avoidable readmissions, improve recovery and support families caring for ageing loved ones.
In the "2026 National Budget", perhaps it's time to ask: Will we finally invest in a system that ensures older Malaysians are not just discharged from the emergency department -- but truly cared for, even after they leave the hospital?
* Prof Dr Mohd Idzwan Zakaria, Universiti Malaya; Assoc Prof Dr Terence Ong Ing Wei, Universiti Malaya and Dr Mark Tay Wen Kuang, Ministry of Health, Malaysia.