Older people have complex and unique primary care needs. The frequent occurrence of co-morbidities, polypharmacy, psychological, social and functional impairments can impact on the way problems present making the diagnosis and treatment more challenging for the primary care physician. The provision of healthcare is becoming more community-based and national service frameworks have highlighted the special healthcare needs of older people. This means that treating older patients will become an even larger proportion of the daily work of the general practitioner. Packed full of practical and down to earth advice for clinicians specialising in the care of older people, this book examines real problems that present on a day-to-day basis in the primary care environment. It provides GPs with specific advice and guidance to help them in the management of the often complex conditions that present in older people. Written by practising clinicians who are experts in the field, this book covers a diverse range of subjects from stroke medicine to incontinence to the role that the voluntary sector plays in the care of older people.
It includes clinical case scenarios throughout and colour photographs in chapters on areas such as ophthalmology and dermatology enable readers to effortlessly understand the points being made. Easy to read and with most chapters co-authored by a specialist and a general practitioner, this book provides GPs, community and practice nurses, and those specialising in the care of older patients with an indispensable resource they can use to find practical advice from specialists in the field, including tips on differential diagnosis and summaries of the existing evidence-base and guidelines on treatment.
Margot Gosney qualified in 1983 at the University of Liverpool. She went on to do her postgraduate training and MD in the North West of England. In 1994 she was appointed as senior lecturer in the academic department of Geriatric Medicine and subsequently to the chair of Elderly Care Medicine at the University of Reading in 2003. She has an interest in both undergraduate and postgraduate education, working as a question writer for the MRCP Part 1 and Part 2 as well as examining for PACES. Whilst in Liverpool she was co-director for three years of the undergraduate curriculum. She is external examiner for six undergraduate medical degrees as well as MSc in Gerontology in two universities. She question writes for the General Medical Council and is a member of the Part 1 PLAB panel. Tess Harris qualified from St George's Hospital Medical School in London in 1988 and has been working as a part-time general practitioner since 1994, in London, Oxfordshire and Berkshire. She has an M.Sc. in epidemiology and has been involved for many years in primary care epidemiology research, with a particular focus on older peoples' health and health care use. Her MD is in this research area and she has also published widely in topical journals.
1. Introduction ; 2. Ageing ; 3. Clinical assessment of the older patient ; 4. Pharmacokinetics and pharmacodynamics ; 5. Cardiovascular disease ; 6. Stroke and transient ischaemic attack ; 7. Neurological problems ; 8. Respiratory problems ; 9. Gastroenterology ; 10. Diabetes and endocrine problems ; 11. Haematological conditions ; 12. Locomotor problems in older people ; 13. Falls and osteoporosis ; 14. Kidney problems ; 15. Ear, nose and throat ; 16. Ophthalmic problems ; 17. Dermatology ; 18. Pressure ulceration and leg ulcers ; 19. Incontinence ; 20. Urology ; 21. Gynaecological problems ; 22. Psychiatry ; 23. Ethical and legal issues ; 24. Vulnerable adults ; 25. Palliative care ; 26. Care home medicine ; 27. Rehabilitation and physical activity ; 28. Social services, community care and benefits ; 29. The voluntary sector