Emergency departments (EDs) are increasingly at the front line of care for older adults, a demographic experiencing rapid global growth. This patient group often presents with complex health conditions, polypharmacy, frailty and cognitive impairment, factors which challenge traditional acute care models. This article explores the clinical, organisational and educational challenges in delivering effective, person-centred emergency care for older adults. It presents evidence-based strategies to improve outcomes, drawing on current frameworks such as geriatric EDs and comprehensive geriatric assessment (CGA). Key challenges identified include overcrowding, limited specialist training among staff, suboptimal environmental design, delayed diagnosis and fragmented communication. Evidence-based solutions include the integration of CGA, development of geriatric emergency nursing roles, interdisciplinary collaboration, targeted workforce education and training, and ED environmental adaptations. Enhancing emergency care for older adults requires a system-wide shift towards age-appropriate, interdisciplinary, person-centred models of care. Policy alignment, workforce capacity building and organisational leadership are essential to delivering safe, effective and compassionate emergency care for this population.