Purpose of review <p>Transitions of care from the emergency department (ED) represent a period of heightened vulnerability for older adults, driven by medical complexity, functional impairment, and social factors. This review examines ED-based geriatric models and interventions aimed at improving transitions of care, with a focus on how outcomes are defined and measured.</p> Recent findings <p>Geriatric emergency department (GED) models emphasize multidisciplinary assessment, targeted screening, and care coordination to address risks during ED transitions. While a growing body of literature describes promising interventions including screening linked to services, care management, medication review, and post-ED follow-up, evidence remains heterogeneous. Outcomes are frequently measured using utilization-based metrics, which may inadequately capture patient-centered goals such as function, symptom burden, and care continuity. </p> Summary <p>GED models provide a valuable framework for identifying risks related to transitions of care for older adults, but current evidence is limited by inconsistent outcome definitions and system-level constraints. Future research should prioritize patient-centered outcomes, pragmatic implementation strategies, and alignment with post-acute care capacity to meaningfully improve transitions from the ED for older adults.</p>