MacMahon D
Camborne/Redruth Community Hospital, Barncoose Terrace, Redruth, Cornwall TR15 3ER, UK.
Age Ageing. 2001 Aug;30 Suppl 3:19-23. doi: 10.1093/ageing/30.suppl_3.19.
The specialism of geriatric medicine has developed considerably in the last half of the twentieth century. In Great Britain it has emerged from its sombre beginnings in Victorian poor law institutions to become one of the largest specialities in medicine encompassing a wide range of disciplines and interests. More recently, there has been a parallel development in "intermediate care" a sweeping phrase that encompasses a wide diversity of practices in a plethora of venues. Although there is considerable attraction in minimising the duration of hospital stay by older people, there is a real risk of intermediate care being used as a euphemism for indeterminate neglect. For older people to benefit from appropriate treatment and care, the lessons learnt by earlier generations of geriatricians, and supported by the international evidence base should not be disregarded. Elderly people need a full multi-disciplinary assessment (comprehensive geriatric assessment) and continued involvement of skilled and trained personnel in their continuing care (geriatric evaluation and management). The recommendations of the British Geriatrics Society on intermediate care are commended and should be adhered to by all planners and providers of intermediate care. There is considerable logic in developing ways in which the two developments can be integrated to build upon the best features of both.
老年医学专业在二十世纪后半叶有了相当大的发展。在英国，它从维多利亚时代济贫法机构中惨淡起步，发展成为医学领域最大的专业之一，涵盖了广泛的学科和兴趣领域。最近，“中间护理”也有了类似的发展，这是一个涵盖众多场所各种不同实践的笼统说法。虽然尽量缩短老年人住院时间有很大吸引力，但中间护理存在被用作不确定忽视的委婉说法的实际风险。为了让老年人从适当的治疗和护理中受益，早期几代老年医学专家吸取的经验教训，以及国际证据基础所支持的经验教训不应被忽视。老年人需要全面的多学科评估（综合老年评估），以及熟练且经过培训的人员持续参与他们的持续护理（老年评估与管理）。英国老年医学学会关于中间护理的建议值得称赞，所有中间护理的规划者和提供者都应遵守。探索将这两种发展结合起来以发挥两者最佳特性的方法，是很有道理的。
