title: [The future of the aged patient at the end of an acute disease].
abstract: Elderly patients play an important role in the inpatient structure of departments of Internal Medicine. Although they pose many difficult problems during their admission due to multiple system disease, the problems often increase at the end of the therapeutic period when discharge from hospital is decided upon. Over half the cases are able to be sent home but the liaison with the domiciliary services is often poor, leading to reiterative hospital admission. A period in a medium-stay unit may provide a solution, but, due to insufficient numbers and uneven distribution, their function does not always meet the required demand: rehabilitation of the patient to his previous life style. Long-stay departments may be justified when there is a loss of autonomy and when regular medical care is needed. The exact place of these medicalised long-stay units within the hospital structure is still a matter of heated argument. What must be avoided is the creation of circuits of transfer of patients from one establishment to another. The present situation could be improved upon by the development of pre-hospital services, a better appreciation of the functional needs of the individual during hospitalisation, and a better liaison between the hospital and domiciliary services, by the creation of a range of options which do not favourise one or the other solution in too theoretical a manner.
mesh_terms: D000208:Acute Disease; D000368:Aged; D003422:Critical Care; D005602:France; D006748:Hospital Departments; D006801:Humans; D007902:Length of Stay; D012866:Skilled Nursing Facilities
vernacular_title: Le devenir du malade âgé au terme d'une affection aiguë.