Residents in selected aged care facilities in Australia (n = 185) and New Zealand (n = 44) completed a 56 item quality of life instrument derived and refined through grounded theory. Ten scales were developed from the items. Analysis of variance (ANOVA) indicated that there were no main differences as a function of cohort (Alzheimer's or non-Alzheimer's) or country of residence (Australia or New Zealand). Significant differences emerged as a function of the source of help in completing the instrument. Where nursing staff assisted residents complete the instrument, scoring indicated that residents enjoyed a better quality of life than if the instrument was completed by the resident alone, or with assistance from non-nursing staff and others, including relatives, welfare students and diversional therapists. Nursing staff rather than non-professional nursing staff tended to work more with non-Alzheimer residents when completing the questionnaire. Significant differences were also discovered in the ranking of concerns on the basis of cohort and country of residence.

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Flecainide is a sodium channel blocker used mainly in the treatment of supraventricular arrhythmias. Central nervous system side effects such as dizziness, visual disturbances, headache and nausea are commonly associated with flecainide, but severe central nervous system toxicity is rare. We report the first case of flecainide toxicity in a patient with end-stage renal failure. Cessation of flecainide therapy resulted in a fall in serum flecainide levels, with associated resolution of adverse central nervous system effects. We also review the pharmacokinetics of flecainide in patients with chronic kidney disease.

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