Background: Sepsis remains a leading cause of mortality, and accurate, early identification of high-risk sepsis patients is essential in elderly adults. Scoring systems, such as Quick Sequential Organ Failure Assessment (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS), are widely used but have limitations in predicting outcomes in elderly patients. The CRP-albumin-lymphocyte (CALLY) score is a potential alternative, but its role in predicting mortality and Intensive Care Unit (ICU) admission in older sepsis patients is limited. Methods: This retrospective cohort study included patients aged 65 years and older admitted with sepsis to a tertiary hospital covering the years 2021 to 2023. Demographic data, qSOFA, SIRS, and CALLY scores, length of hospital and ICU stay, and mortality outcomes were collected. Statistical analyses were conducted using t-tests and chi-square tests, with a significance threshold set at p < 0.05. Results: The study included 150 patients, with a mean age of 81.1 ± 8.3 years. 50 patients (33.3%) died, and 42 patients (28.0%) required ICU admission. Patients who died had significantly higher qSOFA and SIRS scores, but lower CALLY scores compared to survivors. ICU length of stay ranged from 1 to 34 days, with a mean of 10.6 ± 8.4 days. ICU admission rates were higher in patients who died (p < 0.001), but length of stay did not differ significantly between survivors and nonsurvivors (p = 0.129). Although CALLY scores did not significantly differ between ICU and non-ICU groups, qSOFA scores were higher in those admitted to the ICU (p = 0.006). Conclusions: The qSOFA score effectively predicted ICU admission and mortality in older sepsis patients, but its reliability may be compromised in those with cognitive decline. The CALLY score demonstrated potential as an adjunct tool for mortality prediction. Further research is necessary to develop and validate new scoring systems for sepsis assessment in elderly patients.