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Preface 

Preface
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While it is fashionable to lament the perceived future adverse impacts of increasing longevity on society, health care provision, and social services, such doom may be misplaced, as increased longevity is a consequence of better health, and life years gained may be productive and contented. While the recent increase in retirement age can be seen as a purely economic expedient, it also reflects the realities of better health in older people. Nevertheless, towards the end of life, at whatever age this occurs, frailty, memory loss, pain, and multimorbidity are likely to remain problems encountered in years to come as they are now. Evidence on the effectiveness of preventative and therapeutic interventions is increasing rapidly, and approaches to treatment of the older person are changing apace. With more age-related problems becoming treatable or preventable, simply caring for the elderly is no longer an option.

More than in any other specialty, the way the service is delivered and how support is provided in the community are important determinants of health and quality of life in this population, and new models of care are being developed.

This book will give the reader a grounding in current thinking in geriatric medicine, highlight the research which has led to changes in management strategies, point to key sources of up-to-date information on the topic, and probe into questions that still remain to be answered.

The contributors to the book are leading UK specialists in their subject areas. Chapters are written in a concise and economical style that conveys the latest evidence-based practice in the treatment of older people along with expert interpretation of the research literature from a specialist’s perspective. Learning points and illustrations are provided where relevant, as well as up-to-date references for further material, including useful websites.

The book is an easily accessible reference tool for a broad cross section of health professionals who manage older patients in both primary and secondary care, such as geriatricians, general practitioners, nurses, therapists, and clinical researchers, as well as specialists in pain, stroke, dementia, and palliative care services. The topics and issues raised will be of particular interest to professionals involved in the development of health and community services for older people.

What emerges is the complexity of the care of older people requiring collaboration between multiple agencies along with integration of services underpinned by robust channels of communication. Good quality clinical trials are increasingly providing us with effective interventions to treat many of the conditions of old age. Such advances need to be used to influence care provision at the level of policymakers. In addition, legal and physical infrastructures associated with the provision of care of older people, such as access to services and treatments, require updating and enhanced inclusivity. This book is both a guide to best practice and a manifesto for further improvements of evidence-based medicine for the older person.

Frank Lally and Christine Roffe