Inappropriate prescribing in older people

530 and important part of the spectrum of continuing care. Bowman et al. point out that care-home commissioning, provision and regulation currently reflect a social (rather than medical) model of care. They question the distinction between residential and nursing categories, as others have done [8]. They suggest that greater attention to clinical needs may enhance ‘social’ functioning, as well as limiting avoidable acute events and hospitalisations. They also lament the absence of healthcare expertise in UK regulatory bodies, and suggest that systematic ongoing monitoring of health status is required to track care needs and monitor outcomes. All are sensible points. Rather than considering care homes a backwater for unwanted and uninteresting citizens, a more compassionate approach would recognise their necessity, and develop positive policies for meeting the health and social care needs of residents, including adequate provision for medical care, rehabilitation and occupation. High quality nursing home care is possible [9, 10], although there is pitifully little research evidence to guide us. A renewed drive to develop more positive philosophies of care is overdue.