Mostly, my approach is to consider that we, that is the community services (those outside the acute hospital) can and do support a far broader range of patients than people realise and, when working well together, can care for a significant proportion of the people who otherwise arrive at the door of A&E.
In the olden days, over 65 was considered old.
Now, when I meet someone who is 75, I consider them young.
They are in the community, but not in the community in the sense of hospital specialists, rather, they are sitting at their kitchen table struggling with beans on toast, or negotiating the short distance between front and back room
In the hospitals (the hole) we sit and wait.
Eventually, inevitably, the older person will fall-in;
Yes, it is a topsy-turvy world, one of contradictions, complications, improvement and innovation.