Contexts of Care

Abstract

Geriatric medicine is characterized by multiple levels or contexts of care. The geriatrician and his/her team typically care for elderly patients along a continuum of these contexts, stretching from hospitalization for an acute problem, such as a stroke, to rehabilitation on a subacute ward, to convalescence in a nursing home, to continued care at home via a home care program, and finally to a return to primary care in the office. (Conversely, one can view this continuum from the opposite direction, beginning in primary and preventive care and spanning to institutional care.) Each of these contexts of care has its own scope of purpose, its own rationale, its own teams of care professionals, and its own financial considerations and incentives. Proper geriatric care requires familiarity with all these contexts and an understanding of how best to manage patients within them.