About the editor
About the contributors
Abbreviations
Introduction
Gideon Caplan
PART I OVERVIEW
Chapter 1 The biology of ageing
David G Le Couteur, Vasikaran Naganathan, Victoria C Cogger, Stephen J Simpson, & Rafael de Cabo
Introduction
Why do we age? Evolutionary theories of ageing
How do we age? Biological and molecular mechanisms for ageing
How can we delay ageing?
Conclusions
Recommended reading
References
Chapter 2 Comprehensive geriatric assessment
Lisa Kelly and Gideon Caplan
Introduction
Elements of CGA
Assessment setting
Evidence base
References
Chapter 3 Multidisciplinary teamwork
Stephanie Alison Ward and Barbara Workman
The role of healthcare teams
The multidisciplinary team in geriatric medicine
Effective teamwork
Teamwork processes in the geriatric MDT
Summary
References
Chapter 4 Community care for older people in Australia
Gideon Caplan
Introduction
Home and community care
Aged Care Assessment Teams
Home Care packages
HC 4
Transition care programs
Limitations of home care
References
Excerpt from Morituri salutamus
H W Longfellow
PART II THE GIANTS OF GERIATRIC MEDICINE
Chapter 5 Delirium
Catherine McVeigh and Gideon Caplan
Introduction
Clinical features
Medications and delirium
Pathophysiology of delirium
Outcomes
Prevention
Management
Conclusion
References
Chapter 6 Dementia
Dina LoGiudice & Leon Flicker
Introduction and definition
Epidemiology of dementia
Burden of disease
Risk factors and prevention strategies
Clinical features of cognitive impairment and dementia
Assessment and management of dementia
References
Chapter 7 Frontotemporal dementias and related dementia syndromes
Olivier Piguet, Cristian Leyton and John R Hodges
Introduction
Epidemiology
Clinical presentations
Pathology of FTD
Genetics of PPA
Neuroimaging in FTD
FTD-related syndromes
Functional abilities and disease severity
Therapeutic interventions
References
Chapter 8 Behavioural and psychological symptoms of dementia
Michael Woodward
Introduction
Clinical features
Management
Conclusions
References
Chapter 9 Managing urinary incontinence in older people
David Fonda and Catherine DuBeau
Introduction
Age-related changes to the continence mechanisms
Causes and types of incontinence
Urinary retention in older people
Nocturia
Assessment
Management
Personnel involved in management
References
Chapter 10 Mobility, gait, and falls
Jacqueline C T Close & Stephen R Lord
Introduction
Physiology of balance, gait, and mobility
Epidemiology of falls
Risk factors for falls
Assessment of the older person at risk of falls
Interventions to prevent falls
Fracture prevention
Research gaps
Conclusions
References
Chapter 11 Syncope
Mary Anne Kulh
Definition
Pathophysiology
Causes
Clinical history
Clinical examination
Investigations
Management
References
Chapter 12 Frailty
Sarah N Hilmer & Danijela Gnjidic
Overview
Definition
Epidemiology
Pathophysiology and biology of frailty
Clinical implications
Prevention and treatment of frailty
Conclusions
References
Chapter 13 Parkinsonism and related conditions
Robert Iansek
Introduction
Pathophysiological basis for movement disturbance in parkinsonism
Parkinson syndromes: a clinical perspective
Idiopathic Parkinson’s disease
Complications of medical management
Chapter 14 Malnutrition
Renuka Visvanathan
Introduction
Changes associated with ageing
Under-nutrition in older people
Obesity in older people
Conclusion
References
Chapter 15 Osteoporosis in older persons
Oddom Demontiero & Gustavo Duque
Introduction
Epidemiology
Pathophysiology
Clinical approach to the osteoporotic patient
Prevention and treatment
Osteoporosis in residential aged care facilities
Conclusion
References
Chapter 16 Wound care
Jeff Rowland and Colin Kennett
Introduction
Normal wound healing
Commonly encountered wounds
Wound dressings
Assessment
Management
Conclusion
References
Chapter 17 Prescribing medications to older people
Vasikaran Naganathan & David G Le Couteur
Introduction
Comprehensive geriatric assessment
Goals of treatment
Evidence
Under-prescribing
Medication review
Adverse effects
Medication management
Polypharmacy
The acutely unwell older person
Summary
References
When You Are Old
William Butler Yeats
PART III CARE IN CONTEXT
Chapter 18 Caring for older people in general practice
Catherine Regan and Dimity Pond
The context
Health care for older patients in the community
Processes of care in general practice
Managing multimorbidity
Managing non-specific presentations
Important conditions in the community
Prevention, screening, early detection, and modification of risk
Team-based care
Working with families
Advocacy for the patient
References
Chapter 19 Care of residents in residential aged care facilities
Penny Harvey
Introduction
Care needs
Comprehensive health assessment
Advance care planning
Medical illness in the RACF
Communication and continuity of care across settings
Team-based approach to prevention of functional decline
Conclusion
References
Chapter 20 Rehabilitation for older people
Susan Kurrle and Ian D Cameron
Introduction
Older people who might benefit from rehabilitation
Management
The ward setting for rehabilitation and the older person
Communication
Rehabilitation for older people in the community setting
Cost-benefit of rehabilitation for older people
Conclusion
References
Chapter 21 End-of-life care
Colleen Cartwright and Kelly Shaw
Introduction
Clinical issues
Social, psychological, and legal issues
Conclusion
References
Chapter 22 Acute care of the older person
Richard I Lindley
Needs assessment
The evolution of geriatric medicine
The evidence base for acute geriatric care
Data, dogma, and some personal reflections
Conclusion
References
Chapter 23 Post-acute care
Kwang Lim
Introduction
Community services and post-hospital care
Cost constraints and reducing length of stay
What is post-acute care?
Types of post-acute care programs
The evidence
Discussion
Conclusion
References
Chapter 24 Medical care for older people undergoing surgery
Christopher Etherton-Beer
Introduction
Organisation of surgical and peri-operative care
Peri-operative cardiovascular events
Management of other medical problems and complications in surgical patients
Orthogeriatric care
Conclusions
References
Chapter 25 Legal aspects of geriatric medicine
Peteris Darzins and Julian Gardiner
Rule of the law in Australia
All people are equal before the law
Autonomy
The need to address decision-making capacity
How to assess decision-making capacity
Enduring Powers of Attorney
Advance health care directives
Legal rights in residential aged care facilities
Wills
Euthanasia
Summary
References
Chapter 26 Ageing in Australia’s Indigenous and culturally diverse communities
Anna L Howe and Philippa Cotter
Encountering diversity
Diversity in populations and health status
Changing needs and service responses in Indigenous communities
Changing needs and service responses in CALD communities
Special needs within special needs groups
Towards cultural competence
Looking ahead
References
Chapter 27 The economics of ageing
Gideon Caplan
Retirement income
Health care
Aged care
Dependency ratios and carers
References
Do Not Go Gentle into That Good Night
Dylan Thomas
Index
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