Frail older people now contribute the majority of the acute emergency take both medical and surgical. Despite this there is often a lack of confidence and knowledge among doctors and nurses in treating older people in the Emergency Department and on Emergency Assessment Units.From the Preface
Emergency care of frail older people is challenging but very rewarding. Older patients tend to be complex and therefore their assessment needs to be more extensive and include comprehensive geriatric assessment. It is the extras in their assessment that are not usually needed in younger patients, such as cognitive, functional and social evaluations that make the difference in achieving a better outcome.
This book describes the key features of high quality care for frail elderly patients in acute hospital settings. With chapters on assessment and the characteristic non-specific ways that patients tend to present (such as 'confusion', 'collapse query cause' and 'off legs'), this practical guide is ideal to have on-hand. As well as common medical and surgical conditions, it also covers medication management, elder abuse, pressure ulcers and hypothermia, including the physiological changes seen in ageing and ways to define frail patients.
Tables, diagrams and images are ideal for quick reference, and key points are summarised throughout the text to aid comprehension, providing doctors, nurses and therapists with both background and essential information to provide the excellent acute care older people deserve.
HENRY WOODFORD BSc, FRCP Consultant in Elderly Medicine North Tyneside Hospital, North Shields and JAMES GEORGE MBChB, MMEd, FRCP Consultant in Medicine for the Elderly Cumberland Infi rmary, Carlisle Henry Woodford was born in York and went to school in Yorkshire. He then went to medical school at King's College London. During this time he undertook an intercalated degree incorporating physiology. His elective period was spent in British Columbia, Canada. He did his house jobs in the south- east of England but then moved to the north- east for further training. He did his specialist registrar rotation based around Newcastle upon Tyne. One year was taken out of the programme to work at Westmead Hospital in Sydney, Australia. He worked as a consultant geriatrician in Carlisle from 2006 until 2012, when he moved to take up a post in North Tyneside, UK. He is married and has two daughters. James George was born in Derbyshire and qualifi ed in Liverpool. Aft er early training in Liverpool, Leeds and Bradford he was appointed as a Consultant in 1986 in Carlisle. He is the Clinical Lead for Research for North Cumbria University Hospitals NHS Trust. He was a member of the National Institute for Health and Clinical Excellence (NICE) Clinical Guideline Group for the 2010 NICE guidelines on delirium. He is married and has one daughter, who is an occupational therapist.
Foreword. Preface. About the authors. List of abbreviations. Introduction. Assessment. 'Off legs': non-specific functional decline. Atypical presentations. Malnutrition. Dehydration. Electrolyte disturbances. Constipation. Incontinence. Pressure ulcers. Hypothermia. Confusion. Delirium. Dementia. 'Collapse query cause': falls and blackouts. Falls. Syncope. Epilepsy. Surgical care. Abdominal pain. Trauma. Infection. Sepsis. Pneumonia. Influenza. Urinary tract infection. Clostridium difficile infection. Methicillin-resistant Staphylococcus aureus. Infectious endocarditis. Meningitis. Encephalitis. Skin and soft tissue infections. Cerebrovascular disease. Stroke. TIA. Chest pain and shortness of breath. Acute coronary syndromes. Heart failure. Cardiac arrhythmias. Aortic dissection. Pulmonary embolism. Chronic obstructive pulmonary disease. Other presentations. Dizziness. Acute gastrointestinal haemorrhage. Parkinson's disease. Depression. Diabetes. Headache. Acute back pain. Acute joint inflammation. Elder abuse. Palliative care. Medications. List of abbreviations. Index.