Longest-term placement problems in an acute care hospital

The Geriatric Team in the Acute Care Hospital: An Educational and Consultation Modality

“…The delivery of acute, subacute, rehabilitative, and chronic care to elderly people in the acute care hospital is posing major problems to professional and non‐professional health care providers who have not been educated in the special body of knowledge, approaches, and skills needed to care for this rapidly growing group of patients. Because of the increased incidences of acute and chronic conditions, the prolonged recovery times, and the increased incidence of hospital‐acquired illnesses, people over age 65 are hospitalized twice as often as middle‐aged audits and stay twice as long, occupying 30 to 50 per cent of all acute care hospital beds 1,3 . The dysfunctional elderly patient with multiple organ system decomposition stresses the ability of health care professionals to give acute and non‐acute care in the hospital and to implement services that will allow him to return to the community.…”

Elderly Patients in the Acute Care Hospital:

“…For the past two decades, factors associated with delayed discharge of elderly patients from acute care have been examined in Britain, the United States and Canada (Rubin & Davies, 1975;Glass et al, 1977;Sloane, Redding & Wittlin, 1981;Robertson, 1985;Rockwood, 1990;Hertzman, Pulcins, Barer, Evans, Anderson & Lomas, 1990;Falcone, Bolda & Leak, 1991). A 1984 report by the Metropolitan Toronto District Health Council estimated that 13.9% of acute care beds in the city were occupied by elderly patients waiting for long-term care placement.…”

Work organization and patient care staff injuries: The impact of different care models for “alternate level of care” patients

“…These downsizing pressures occurred at the same time as the acute-care system faced increasing demands to handle elderly alternate level care (ALC) patients, a result of the combination of an ageing population and a shortage of long-term care beds [Barer et al, 1987;McGrail et al, 2001]. ALC is a term used to describe patients in an acute-care hospital bed who no longer require acute medical care because they are medically stable but whose discharge is delayed usually by the unavailability of post-hospital care [Sloan et al, 1981;United Hospital Fund, 1989].…”