Intended for healthcare professionals

Views And Reviews Medicine and books

Health care for older people; Community care of older people

BMJ 1998; 316 doi: (Published 11 April 1998) Cite this as: BMJ 1998;316:1176
  1. David Griffith., consultant physician
  1. Care of Older People, Mayday University Hospital, Croydon

    Health care for older people

    Steve Iliffe, Linda Patterson, Mairi Gould

    BMJ Publishing Group, £17.95, pp 177

    ISBN 0 7279 1192 9

    Community care of older people

    Ed David Beales, Michael Denham, Alistair Tulloch

    Radcliffe Medical Press, £17.50, pp 224

    ISBN 185775 032 2

    Problems in the care of elderly people are often “messy.” That is to say they are not straightforward, unidimensional issues but involve complex interplays of factors, often with more unknown factors and irreversible elements than in other branches of medicine. “Clean” problems — does treatment x help condition y? — are less commonly encountered and usually form only part of an overall scenario. This lack of clean problems is just one of the difficulties bedevilling the development of evidence based medicine in the care of elderly people.

    Just as the problems are messy so are the solutions. Professor Grimley Evans has emphasised the place of both “therapeutic” and “prosthetic” approaches — the former being an attempt to cure or modify the biological problem, the latter accepting that this may not be possible but seeking to modify the environment to help …

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