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Biomedical subjects

M Hildick-Smith

Publications and source records attributed to M Hildick-Smith.

16 recordsLinked to original sources
PubMed1985

Geriatric rehabilitation in day hospitals.

The main objective of geriatric day hospitals, that of physical rehabilitation of elderly patients mainly with strokes and arthritis, is matched by their facilities and their medical, nursing and therapy staffing. Patients attend by ambulance on 1 or 2 days a week for about 3 months for assessment and treatment, while continuing to live at home. Day hospitals are a popular and effective resource for the rehabilitation of selected patients, though not necessarily cheaper than institutional care. Problems remain in the separation of social care and psychogeriatric patients and in ambulance transport.

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PubMed1984

Geriatric day hospitals--changing emphasis in costs.

One of the factors which may have influenced day hospital expansion is that day hospital treatment was earlier found to be cheaper than in-patient treatment, as some of the 'hotel' costs were avoided. The increasing price of ambulance transport has reduced this advantage. Further reduction occurs if the expenses of keeping a patient at home (community services, share of housing, etc.) are set against in-patient costs. Using such detailed comparisons, treatment up to twice weekly at a Day Hospital provides good value for money, but more frequent treatments can prove costlier than in-patient or residential care. Realistic attempts are now being made to cost a complete course of treatment, for example three months' visits to a day hospital. Depending on whether this is regarded as equivalent to 15 or 10 weeks as an in-patient, the relative cost of day hospital treatment is 32-90% of in-patient costs. 'Throughput' is as vital to day hospitals as to wards, and the average number of visits for day hospital treatment has decreased over the years from 40-20, and the recommended size from 50 to 30 places. Critics of comparisons between in-patient and day patient treatment emphasize that we are not comparing like with like. Day hospital treatment relates more closely to independence and accords with the preferred wishes of most patients and families. Costing involves not only money but staffing and here the day hospital continues to show advantage.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1983

Natural history of coal-workers' pneumoconiosis in men over 65.

Between 1975 and 1977, 107 Kent miners aged 65 or over who had coal-workers' pneumoconiosis (CWP) were examined for current disability. The men had worked an average of 43 years underground. Forty-nine had simple CWP, and 48 complicated (33 'A', 25 'B' and 'C' shadows). In only 34 had their CWP category increased during the last 21 years, though 62 had had their disability percentage increased (by an average of 20 per cent). Seventy-two of the 95 men tested by spirometry showed normal results for their ages. No clear relationship existed between spirometry results and category of CWP. The complicating effects of obstructive airways disease or cigarette-smoking were difficult to disentangle from those of CWP. Coal-workers' pneumoconiosis is increasingly a disease of elderly miners, and can be more benign than was previously thought. It is in these miners' interests that other (perhaps treatable) causes should be sought for any chest symptoms.

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PubMed1982

Parkinsonism in the elderly.

Considerable advances have been made in the treatment of parkinsonism in the last 10 to 20 years and have brought great benefit to patients of all ages, including the elderly. Whilst levodopa-containing drugs are the mainstay of treatment in the early disabling stages of the disease, providing increased mobility and independence, longer life expectancy and a shorter period of terminal immobility, as patients live longer more advanced manifestations of the condition develop which are more difficult to treat. Diagnostic difficulties in the elderly are discussed and the main conditions affecting treatment and treatment of the different stages of the disease are reviewed.

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PubMed1980

Geriatric day hospitals: practice and planning.

A study of 1026 day-hospital patients who attended the three geriatric day hospitals in East Kent in the year 1971-2 showed similar results to those obtained from previous studies with regard to age and sex of attenders, diagnoses and average length of attendance. Day-hospital practice was viewed within the context of the other essential services provided for the elderly in this retirement area. The lack of day centres and psychogeriatric day hospitals and its effects on day-hospital practice are discussed with reference to the low NPI (new patient index) figures in the three units. Each area's yearly referrals are related to its resident elderly population and vary from 3-15 patients per 1000 (average 7.7 patients). Since an average patient attends for three months or more, something between 1 and 2 places per 1000 elderly would be required if they attended two days a week, and up to 3 places per 1000 elderly if they attended three days a week. This result suggests that the national guide-line of 2 places per 1000 elderly may be sufficient to meet present local referrals; though it cannot be assumed that it measures need.

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PubMed1978

Day hospitals.

Explore the source record for details and available documents.

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PubMed1978

Your tomorrow.

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PubMed1974

Epilepsy in the elderly.

Among 50 geriatric inpatients (average age 79) with late-onset epilepsy (average duration two years), 28 had grand mal attacks, 12 had focal attacks, seven had both. None had petit mal, confirming its rarity in the elderly. The epilepsy followed cerebrovascular disease (usually with hemiplegia) in 21 patients (8 per cent of all our patients with hemiplegia in the two-year study period developed epilepsy). Associated conditions included dementia in seven; and cerebral tumours (usually metastases) in five. This latter group survived less than two months on average from the onset of their attacks. The majority of patients (42 out of 50) were unfit for full neurological investigation; and the dangers of some procedures in the elderly are stressed.

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PubMedDate not supplied

Late-onset epilepsy.

The incidence of epilepsy rises progressively in old age. However, with good control of fits and sensible advice, elderly epileptic patients can be supported and helped to maintain an appropriate level of independence in their own homes.

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