Death and dying

Breaking bad news 638 HOW TO . . . Break bad news 639 Bereavement 640 HOW TO . . . Promote a ‘healthy bereavement’ 641 Palliative care 642 Symptom control in the terminally ill 644 HOW TO . . . Prescribe a subcutaneous infusion for palliative care 646 Documentation after death 648 Other issues after death ...

Drugs

Pharmacology in older patients 126 Prescribing ‘rules’ 128 Taking a drug history 130 HOW TO . . . Improve concordance 132 Drug sensitivity 134 Adverse drug reactions 135 ACE inhibitors 136 HOW TO . . . Start ACE inhibitors 137 Amiodarone 138 HOW TO . . . Manage amiodarone-induced thyroid dysfunction 139 Analgesia 140...

Ageing

The ageing person 2 Theories of ageing 3 Demographics: life expectancy 4 Demographics: population age structure 6 Demographics: ageing and illness 8 Illness in older people 10 There are many differences between old and young people. In only some cases are these changes due to true ageing, ie due to changes in the characteristic(s) compared with when the person was young....

Eyes

The ageing eye 568 Visual impairment 569 Blind registration 570 HOW TO . . . Optimize vision 570 Visual hallucinations 571 Cataract 572 Glaucoma 574 Age-related macular degeneration 576 HOW TO . . . Use an Amsler grid to detect macular pathology 578 The eye and systemic disease 579 Drugs and the eye ...

Gastroenterology

The ageing gastrointestinal system 352 The elderly mouth 354 Nutrition 356 HOW TO . . . Manage weight loss in older patients 357 Enteral feeding 358 HOW TO . . . Insert a fine-bore NG feeding tube 359 The ethics of clinically assisted feeding 360 Oesophageal disease 362 Dysphagia 364 Peptic ulcer disease ...

Rehabilitation

Introduction 72 The process of rehabilitation 74 Aims and objectives of rehabilitation 75 Measurement tools in rehabilitation 76 Measurement instruments 78 Selecting patients for inpatient rehabilitation 80 Patients unlikely to benefit from rehabilitation 82 HOW TO . . . Plan a complex discharge 83 HOW TO . . . Conduct a MDT meeting ...

Finances

Making a will 678 Taxation 679 Pensions 680 Benefits 682 • Everyone over 18 should make a will. This need not be complicated—there are cheap will writing ‘kits’ available to buy, and forms can be downloaded from the Internet even more cheaply, eg http://freeguard.co.uk/aboutus.aspx •...

Infection and immunity

The ageing immune system 606 Overview of infection in older people 608 HOW TO . . . Accurately diagnose infection in an older patient 609 Antibiotic use in older patients 610 Meticillin-resistant Staphylococcus aureus 611 Disease caused by MRSA 612 HOW TO . . . Control MRSA 613 Clostridium difficile-associated diarrhoea ...

Renal medicine

The ageing kidney 384 Acute kidney injury 386 Acute kidney injury: management 388 HOW TO . . . Perform a fluid challenge in AKI/anuria 389 Chronic kidney disease 392 HOW TO . . . Estimate the glomerular filtration rate 393 Chronic kidney disease: complications 394 Renal replacement therapy: dialysis 396 Renal replacement therapy: transplantation ...

Cardiovascular

The ageing cardiovascular system 256 Chest pain 258 Stable angina 260 HOW TO . . . Rationalize antianginals in older patients 261 Acute coronary syndromes 262 Myocardial infarction 266 Hypertension 268 Hypertension: treatment 270 HOW TO . . . Use antihypertensives in a patient with comorbid conditions 271 Arrhythmia: presentation 272...