Abstract

Admission to hospital is a terrifying and potentially life-threatening event for elderly persons. In our efforts to increase efficiency by decreasing the length of hospital stay, elderly persons are often seen as an impediment to speeding up the "belt line" when they are unable to meet ambitious targets set for recovery and create unwanted variances in clinical pathways or care maps developed by professionals. Clients who have moved beyond what is considered the "acute period" of their care (referred to in the past as bed blockers) are often labelled ALC (Alternate Level of Care). At this point the goal of their care has become more rehabilitative in focus - a goal that does not, to date, factor into acute care. It is well known that Alternate Level of Care clients are discharged more quickly and effectively if they are more highly functioning. Logically, a plan of care that includes maintaining or improving functional capacity through a rehabilitative focus would assist and support discharge from acute care facilities. Ultimately, the separation of acute, rehabilitative and long-term care is not a good fit with the needs of the elderly. All clients, regardless of their age, consume service on a horizontal continuum.