Hospital care. Levels

Health care for the elderly is vertebra in hospital care (with different levels, intensities and objectives), institutionalized non-hospital care (residential and social health centers) and outpatient care (primary care, outpatient or home care). In this chapter we will talk about the different models and levels of oriented towards elderly patients.

First you will see the care of acute pathologies. People over 65 years of age increasingly form the bulk of patients admitted to a general hospital for acute pathology, a fact that not only depends on demographic changes. Due to the characteristics that differentiate the geriatric age group from the group of younger adults, it is increasingly evident that the care of one and the other cannot be the same.

Older people in a process of exacerbation have a high risk of functional loss, regardless of the pathology that causes it. From the geriatric point of view and through interdisciplinarity, more and more specialized care units for elderly patients have been created in the hospitals of our environment.

UGA

First of all there are Acute Geriatric Units (UGA), which are specialized hospitalization units, designed to care for frail elderly with acute health problems and at the same time help maintain or achieve independence in the basic activities of daily life. The key elements are a suitable and adapted environment, care centered on the patient and his / her family or caregivers, discharge planning, and an ongoing review of medical care.

UFISS

Below are the geriatric consultation units or UFISS (Interdisciplinary Social Health Functional Units), which are made up of a group of different professionals who work together to offer advice to other health professionals who offer care to frail elderly patients, who require health care in specialized units (coronary, trauma, surgery, neurology, etc.). This advice is carried out through a comprehensive geriatric assessment and its objective is to maintain and recover the functionality of the elderly person.

Home care

Once the patient has stabilized, if they cannot return home immediately and require adaptation or recovery of lost functions, they can be admitted to so-called mid-stay or convalescent hospital units. In them, patients are cared for who, once the acute phase of their pathological process (new or exacerbating), require medium-term treatment with medical care and intensive nursing and rehabilitation care, all with the aim of regaining independence, returning home and reintegrating into community life.

Long stay units

In the case of not being able to reach this last objective of returning to the community, even after intensive rehabilitation (or if they are not able to take advantage of the latter), there are long-stay units, residential centers in which complex health control care is offered to people with a high level of dependency and complicated health problems who cannot receive the necessary care at home. They can be permanent, in the case that the socio-sanitary problem of the care is persistent, or intermittent, in the case that they are offered as temporary or rest support to families and occasional caregivers.

In our country you are medium and long stay units —Especially the latter — are regulated by the health and social health laws and regulations of the Autonomous Communities, so that the specific requirements to be a taxpayer for this type of care vary in each of them, although in general they are very similar.

Ambulatory care

Hospital care, in its different facets, is closely interrelated with outpatient care, either in geriatric outpatient clinics, directly hospital but outpatient, or in home hospitalization units or services, which offer quasi-hospital care at the patient's home. For all this it can be seen that the division into different types of attention is rather didactic and simplified than a real separation.