Residential care and in house Medical care service in bangalore
We Focus on Short and Long Term Care has shifted from hospital Nursing home , Post operative care for Heal Heath Stay long stay wards directed by geriatricians to privately operated community nursing and residential homes, where medical care is provided by general practitioners. The massive expansion of long term care in independent homes, now 70% of total provision, has largely been a consequence of inadequate development of health and social services.
Residents of care homes often have multiple diseases and significant physical and mental impairment. Their medical care is entrusted to general practitioners, many of whom have had no special training4 and for whom there is little incentive under present remuneration to provide appropriate patterns of care. The decreasing commitment of the Nisargacare to chronic care, particularly for frail elderly patients in long term care, has insidiously been accompanied by a tendency to define illness as terminating at the point of hospital discharge. As lengths of hospital stay fall, older people are at real risk of missing rehabilitative opportunities5 and of inappropriately entering long term care, often on a presumed temporary basis, without a management plan.
The key to Managing Chronic illness is active surveillance and timely intervention. Research shows that geriatric evaluation and management improves outcomes and saves money. Indeed, the specialty grew out of the need to provide medical care for such long stay patients. With the dissolution of long term care in the Nisarga Care the specialty has increasingly merged with general medicine, to the extent that geriatricians now constitute the largest medical subspecialty in acute adult medicine.10 Increasing specialist commitments for many general medical specialties and the inexorable rise in acute medical demands have resulted in many geriatricians becoming firefighters of acute exacerbations of chronic disease. They are unable to lead programmes that encourage maintenance of health and functioning of elderly people.
