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The findings from this study show the use of the Emergency Department of a central Athens hospital in 1988 by over 70 year olds. Interviews with staff illustrated varying perceptions of their role in relation to the elderly, associated with occupation and specialty. Findings from interviews with 100 subjects and accompanying persons using the service investigated the circumstances surrounding the attendance at the hospital emergency department and the role of the family in decision making and support. Interviews with a selected subsample of 12 frail elderly people with complex health and socio-economic problems and/or their carers illustrated the lack of alternative social and medical support services leading to inappropriate hospital usage, to difficulties and dilemmas for family carers and inadequate care for the isolated elderly.