Geriatric care in the United Kingdom: an American perspective.

Geriatric care is a complex and challenging aspect of health care. The United Kingdom, with 13.6% of its population over 65 years of age, compared to 10.1% in the United States, has given special attention to this field. Characteristics of the British system include financing through the National Health Service, existence of a specialty of geriatrics, absence of "nursing homes," emphasis on home care, and avoidance of "heroics" for the terminally ill. While British life expectancy at birth is longer than that for Americans, the opposite is now true for those over 65. The British have made efforts to maximize efficiency in a high-demand, comparatively low-resource context. But there are limits to which professional dedication and patient manipulation can be pushed. Some new policy directions-primarily aimed at prevention and other methods of reducing demand, other than reimposing financial barriers-may have to be explored.