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Although most urgent care of the elderly occurs in primary care, more and more older people are visiting emergency departments (ED) and accessing urgent health and social care services. EDs must be supported to deliver the right care for these people, as no one part of the health and social care systems can manage the problem in isolation.
So says The Silver Book, the result of a UK project involving 13 major health organisations (including the British Geriatrics Society and the College of Emergency Medicine) that was published in June this year.1 It aims to give advice on the care of the elderly in the first 24 h of an urgent or emergency problem. The concept is similar to the Silver Book published by the Royal Australasian College of General Practitioners that offers guidance on the medical care of older persons in residential care facilities for the aged.2 Below are some key messages from the UK version which is essentially a distillation of good, simple, clinical principles, allied with sound common sense and wisdom; …
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