Intermediate care (IC) is a planned, structured service designed to facilitate the transition between high-intensity acute care and a person’s long-term residence. It functions as a necessary bridge for individuals, often older adults, who have experienced illness, injury, or frailty that temporarily reduced their ability to live independently. The services are time-limited, aiming to help people recover their functional abilities following a medical event.
Defining the Role of Intermediate Care
Intermediate care is defined by its core philosophy of maximizing independence and functional recovery. This service has a dual function within the broader healthcare system. One primary purpose is the prevention of unnecessary hospital admissions by offering rapid response or crisis intervention to individuals in the community who are experiencing a sudden deterioration of health. By providing intensive, short-term support in a non-hospital setting, these teams can stabilize a person’s condition and prevent a visit to the emergency department.
The second function of IC is to facilitate timely discharge from an acute hospital setting. For a patient who is medically stable but not yet strong enough to manage at home alone, IC offers a safe environment for recuperation. This support is often described as “reablement,” which focuses on helping individuals regain lost skills and confidence in performing daily activities. The goal of reablement is not to do tasks for the person, but to support and encourage them to do things themselves, such as dressing, cooking, or mobilizing safely.
This structured, goal-oriented approach ensures that the recovery process is focused on returning the individual to their previous level of function, or helping them adapt to a new one. The service provides a period of intensive assessment and rehabilitation, preventing a premature move into long-term residential care.
Types of Intermediate Care Settings
Intermediate care services are delivered across various physical environments, depending on the person’s clinical needs and the level of support required. One common model is Home-based Intermediate Care, which is delivered directly to the individual’s residence. This domiciliary care model adheres to a “home first” philosophy that recovery is often best achieved in a familiar environment. Teams providing this care may include nurses, physiotherapists, and occupational therapists who visit frequently to provide tailored support and rehabilitation exercises.
For individuals who require a more intensive level of support or whose homes are not immediately suitable for rehabilitation, Bed-based Intermediate Care is available. These units are located within community hospitals or dedicated standalone facilities. This setting offers 24-hour care and a higher staff-to-patient ratio than home care, which is suitable for complex rehabilitation needs. The environment is designed to be less medically intense than an acute hospital, promoting a focus on recovery and daily living skills.
A third delivery model is Residential Intermediate Care, where services are provided in a dedicated unit, often situated within a residential or nursing home. This option provides a temporary residential placement where the individual receives rehabilitation alongside personal and social care.
Patient Eligibility and Time Limits
Access to intermediate care is determined by a person’s clinical status and specific functional needs following an illness or injury. A person must be medically stable, meaning they no longer require the specialized resources or continuous monitoring of an acute hospital ward. Eligibility is centered on the requirement for a period of rehabilitation, intensive assessment, or recuperation to regain independence. The patient must demonstrate the potential to improve their physical or mental function within a short timeframe to qualify for this level of care.
Intermediate care is a time-limited service. While local policies may vary, the maximum duration for this type of support is established as no longer than six weeks. The goal is to maximize functional improvement within this window, enabling the individual to transition safely either back to full independence or to a lower level of long-term care if needed.