By Margaret Rees, Louis Keith

Care of the older sufferer is characterised by means of expanding prevalence of persistent and acute ailments, with many sufferers being affected by a number of stipulations concurrently. The susceptibility to sickness raises not just due to physiological elements in relation to the getting older technique, but in addition because of alterations in way of life, similar to diminished mobility. matters in relation to polypharmacy are exacerbated via matters approximately compliance, for instance in sufferers experiencing cognitive decline. judgements approximately applicable therapy are advanced by means of the truth that a few of the basic values that may be relied upon as a advisor in more youthful contributors, don't observe within the older sufferer. This booklet is designed to teach gynecologists approximately those concerns. It attracts upon the event of experts in various scientific and non-clinical specialties, reports present wisdom of the issues encountered in taking care of the aged woman sufferer, and indicates guidance for most sensible perform.

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Semenza JC, Rubin CH, Falter KH, et al. Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med 1996; 335(2): 84–90. Michelozzi P, de Donato F, Accetta G, et al. Impact of heat waves on mortality – Rome, Italy, June–August 2003. JAMA 2004; 291(21): 2537–8. Faunt JD, Wilkinson TJ, Aplin P, et al. The effete in the heat: heat-related hospital presentations during a ten day heat wave. Aust NZ J Med 1995; 25: 117–20. Lye M, Kamal A. Effects of a heatwave on mortality-rates in elderly inpatients.

G. if need to deploy extra staff ). Needs to be based on local information and carefully evaluated Home outreach visits to vulnerable persons Requires some pre-existing register of ‘vulnerable’ individuals Evacuation of vulnerable persons from their homes to cooling centers Using a registry of vulnerable people, who are visited at home, and evacuated, if necessary Electricity companies cease disconnection for non-payment Most important where population relies heavily on air conditioning (as in the US) Water companies cease disconnection for non-payment Fan distribution Fans are effective when they circulate cooler air, but not above temperatures around 35–37°C Source: based on reference 45.

Collins KJ, Exton-Smith AN, Dore C. Urban hypothermia: preferred temperature and thermal perception in old age. Br Med J (Clin Res Ed) 1981; 282(6259): 175–7. Keatinge WR, Coleshaw SR, Easton JC, et al. Increased platelet and red cell counts, blood viscosity, and plasma cholesterol levels during heat 10. 11. 12. 13. 14. 15. 16. 17. 18. 25 stress, and mortality from coronary and cerebral thrombosis. Am J Med 1986; 81: 795–800. Kovats RS, Hajat S, Wilkinson P. Contrasting patterns of mortality and hospital admissions during heat waves in London, UK.

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