The Discharge Clock.

Cognitive impairment is common yet underrecognized in older emergency department (ED) patients.1 Estimates suggest that nearly 2 in 5 older adults in the ED have dementia or cognitive impairment,2 and up to 60% of these may be previously unrecognized.3 Patients with cognitive impairment discharged home from the ED are at increased risk of ED return visits and hospitalization, medication errors, and missed outpatient follow-up.4,5 Improved cognitive impairment screening is a high priority in geriatric emergency medicine.