It's tough when they get admitted, even for obs.
When 90 year old grandma gets obs because she "doesn't feel right", she gets evaluated by PT who states she's too weak to get around by herself and is too big of a fall risk. Care management finds out she lives at home alone. Takes a day to get in contact with family. Family doesn't want to take here home. Attempt to arrange subacute rehab/SNF. Her insurance will only cover two in the area. Family takes another day or two to decide on which one. Said rehab doesn't have a bed available at that moment. Grandma gets delirious overnight - ends up medicated, CTs, more labs, neuro eval, etc...
Not saying that the ED doc is originally wrong for bringing Grandma in - we do what we have to do. It's just not always easy to rapidly turn these people around. 35 YO with -trops and -stress? Sure. 90 year old granny? Not so much