Extended care: medical care of the elderly disabled

Geriatric medicine has now been practised as a specialty for 30 years; there is still argument as to its usefulness, and it is not regarded as an attractive career. At the same time there is a large gap between the standard of acute medicine an that offered to people with continuing disabilities, most of whom are elderly. If this area of medicine is to become more effective, it should be an extension of the responsibilities and activities of the medical centre, practised by a hospital based team, complementing the existing activities of the family doctor and the acute hospital. This method would not only raise the standard, but provide opportunity for a reasonable career. Medical care should be arranged according to disability--not according to age. The name 'extended care' referring to the method of practice, could well replace the worn out label of 'geriatric', which gives unnecessary emphasis to old age. But more important than what it is called, is how it is performed.