Medical care of the elderly in the nursing home

The Birth of Geriatrics in America

“…The nursing home with the newly energized clinical geriatric medicine staff and the newly created clinical programs was also a “natural” site for each community's increasing needs for rehabilitation programs. Thus, a new entity was evolving in the United States with the designation “subacute units.” These units derived in part from the geriatric fellowship efforts and in part independent of and contributing to the fellowship efforts . The nursing home, even with its combination of subacute beds and lifelong care beds, still presented an incomplete array of health challenges, so ambulatory care for community residing elderly adults was added to the spectrum.…”

“…Thus, the rise of “community rehabilitation centers” within the nursing homes, the so‐called subacute treatment sites, has changed health care. The community rehabilitation centers enhanced the status of the nursing homes and helped bolster the financial integrity of the hospitals …”

“…At least three academic nursing homes were already functioning when Robert Butler beautifully labeled this development in clinical medicine, in research, and in education with his so‐useful sound bite and phrase “teaching nursing home.” Among the already existing and teaching entities, the academic nursing homes were at the Jewish Institute for Geriatric Care, Long Island Jewish Hillside Stony Brook; the Nursing Home at Mount Sinai City Hospital at Elmhurst; the Philadelphia Geriatric Center; and the Hebrew Rehabilitation Center of Boston and many others.…”