Editor—Any search for clarity or consensus on the meaning of intermediate care, as discussed by Melis et al,1 is doomed to end in disagreement and disappointment. Much of the confusion stems from misunderstanding it as a medical intervention.
Intermediate care is a function or form of assessment and care and case management that challenges the one size fits all approach in favour of individually tailored efforts to meet needs, promote independence, and prevent further disability and distress. These tasks are not simply targets for health services. Intermediate care exposes the interdependency between health and social care (as well as housing, voluntary, and family support systems). If a definition is still needed, all these should help to shape the term.
The voices of older people also need to influence such debates. In our experience the term intermediate care is rather meaningless to most people receiving it, but they do recognise a helpful, joined up, and reliable service if they are lucky enough to meet one. They do not mind whether the system is a trailblazer or troubleshooter, but they are affected if it is inaccessible and potential referrers are not sure of its criteria. So definitions matter.
Older people often wonder why services only last up to a maximum of six weeks, but that's another definitional problem.
Competing interests: The authors have received funding from Help the Aged to research intermediate care in the voluntary sector.
References
- 1.Melis R, Olde Rikkert M, Parker SG, van Eijken M. What is intermediate care? BMJ 2004;329: 360-1. (14 August.) [DOI] [PMC free article] [PubMed] [Google Scholar]