So what is intermediate care? Intermediate care—sometimes also called reablement care—is a level of healthcare that falls between acute care and long-term care. It is designed to provide short-term rehabilitation and support for adults who are recovering from an illness or injury but do not require intensive care in a hospital or a long-term care facility, such as a nursing home.
Acute care is the care provided in a hospital for illnesses or injuries requiring immediate medical attention. Long-term care, on the other hand, is the type of care provided for individuals with chronic conditions or those who require ongoing support and assistance as they age.
Intermediate care bridges the gap between these two levels of care by providing less intensive support for adults recovering from an illness or injury. Note that intermediate care can be provided in one’s own home or in a residential care home.
Intermediate Care Units vs. Intermediate Care Facilities
Intermediate care units
Having looked at intermediate care, it is also worth looking at intermediate care units, as they can come up during the discussion of what is intermediate care.
Unfortunately, there isn’t an agreed internationally binding definition of what is intermediate care or an intermediate care unit (IMC or IMCUs). For now, though, some studies have observed that in hospitals, intermediate care units are specialized units that provide a level of care that falls between the intensive care provided in an Intensive Care Unit (ICU) and the general care provided in a hospital general ward.
They can be both independent or incorporated units within the ICU. IMCUs can act as a “step-up” or “step-down” unit between the general ward and the ICU. They are designed to provide close monitoring and support for patients who are critically ill, injured, or who require intensive medical intervention. However, they are not as intense as an ICU.
Patients in an IMCU are typically under close monitoring and have frequent check-ins by the healthcare team. They may have multiple IV lines, monitoring devices, and other equipment to help manage their condition. Additionally, family members may be allowed to visit with certain restrictions.
IMCUs are also used to admit patients from the emergency department or recovery ward. It is an integral part of the healthcare system, providing care for patients experiencing severe and complex medical conditions though not requiring the level of care provided in an ICU. They play a vital role in facilitating patient recovery and improving outcomes.
Intermediate care facilities
Intermediate care facilities (ICFs) are long-term care facilities designed to provide custodial care for individuals who cannot care for themselves because of mental or physical infirmity. They are typically used by people with disabilities or non-acutely ill but can also provide a wide range of benefits for patients of all ages.
Some of the benefits of using intermediate care facilities include the following:
- Affordability: Intermediate care facilities can be more affordable than other long-term care options, such as skilled nursing facilities, as they typically provide less intensive medical care. This can make them a more cost-effective option for individuals and families looking for a long-term care solution.
- Resident independence: In these long-term care facilities, residents are enabled to maintain their independence and autonomy as much as possible. Should a resident need help, nurses can assist with activities of daily living, such as bathing and dressing, while allowing residents to make their own decisions and maintain their independence.
- Customized quality care: Intermediate care facilities are designed to provide very specific services to their residents, especially those with mental or physical infirmities. This means that care is customized to meet the unique needs of each resident. Nurses and physicians ensure that each resident receives care that’s working for them, and small wins are always celebrated.
- Regulated care: All intermediate care facilities are required to meet certain state and federal laws. These long-term care facilities are also subject to regular inspections and audits at the state level to ensure they provide their residents with the appropriate level of care. This helps ensure that residents are receiving the best possible care and that the facility complies with all applicable laws and regulations.
So how does an intermediate care unit compare to an intermediate care facility? As shown above, these two are 100% different, serving different patients with different care needs at different levels.
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ICF Model Examples
Typically, when discussing intermediate care facilities, a question about ICF model examples might come up. In our discussion of what is intermediate care, we mentioned that there isn’t an internationally agreed-upon definition of intermediate care and intermediate care units.
However, ICF models are clearly related to ICFs. A stand-alone ICF is a developmentally delayed or chronic mental illness setting. It can be either a large residential facility or a ‘group home’ in the community.
The ICF, or International Classification of Functioning, Disability, and Health, is a model that comprehensively describes how a person’s health condition affects their functioning and disability.
It creates a common language and framework to evaluate the level of function of an individual in their unique environment. The ICF emphasizes the significance of the interplay between internal and external factors and is divided into three main components that are crucial in understanding an individual’s overall health status:
- Body Functions and Structures: This includes the physiological functions of the body and the anatomical structures that support them, like vision, hearing, and movement as well as the eyes, ears, and muscles that support these functions.
- Activities and Participation: This includes what a person can do in their daily life, such as self-care, communication, and mobility. It also includes the person’s social involvement, such as work, leisure activities, and social interactions. The ICF framework emphasizes that health is not just a matter of the absence of disease or disability but also the presence of the ability to participate in daily life.
- Personal and Environmental Factors: This refers to the things in a person’s environment that can impact their health and functioning, such as their social and economic conditions, access to healthcare, and the attitudes of society towards them. It also includes the individual’s personal factors, such as age, sex, and cultural background.
Notice how this does not directly deal with intermediate care units, nor does it seem to relate directly to the intermediate care examples we listed above.
Instead, the ICF framework provides a holistic approach to understanding functioning and disability by emphasizing the interplay of internal and external factors. This helps to move away from a traditional “medical model” that focuses solely on the diagnosis and treatment of disease, and instead focuses on the person’s capacity, performance, and the context in which they live.
In 2003, World Physiotherapy adopted a motion supporting the implementation of the ICF in physiotherapy. This emphasizes the importance of ICF in physiotherapy and in understanding the functioning and disability of patients and providing appropriate care.
Our Current Understanding of What Is Intermediate Care
As stated in a research paper discussing what is intermediate care, intermediate care is an emerging concept in healthcare that may offer alternatives to hospital care for elderly patients. Still, there is a lack of agreement on the definition of intermediate care.
The research notes that the term was introduced in the United Kingdom’s NHS Plan and refined in the national service framework for older people, but it seems to arise out of a policy imperative rather than an analysis of scientific evidence.
Professional statements of good practice have followed the political decision that reconfiguration of the health service would include investment in intermediate forms of care, but different organizations have different definitions of what constitutes intermediate care.
This lack of a clear definition makes it difficult to compare the results of research projects, identify gaps in current knowledge, or critically appraise the benefits attributed to intermediate care.
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