Investigation of the Aged Sick in Their Homes

Exton‐Smith, A. N.

doi:10.1136/bmj.2.4777.182

Cited by 10 publications

(5 citation statements)

References 3 publications

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“…Indeed, one of the authors of the original scale (Exton-Smith) broadened the scope of his inpatient practice to conduct home visits. 26,27 We do not expect that this exact tool will be widely used. It does not have the predictive validity to identify with complete accuracy those who will die.…”

Section: Discussionmentioning

confidence: 99%

Validity of an early risk score for older adults

John

Montgomery²

2014

J R Coll Physicians Edinb

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Objectives: To determine if a risk score developed in hospitalised older adults in the UK in 1962 is correlated with other measures of health and if this risk score predicts death or institutionalisation in community-living older adults. Methods: A total of 1,735 older adults residing in the community in 1991 were followed over five years We replicated the original risk index, a composite score of cognitive status, disability and continence. Other measures included age, gender, education, self-rated health (SRH), life satisfaction (LS) and frailty. Death and nursing home (NH) admission were determined five years later. Results: The risk score was strongly associated with frailty, SRH and LS. The index predicted mortality and NH use: The adjusted odds ratio (95% confidence interval) from multinomial logistic regression models was 0.74 (0.69, 0.79) for death and 0.74 (0.67, 0.83) for NH. Conclusions: A risk score devised to measure inpatient rehabilitation also predicts outcomes in community-dwelling older adults. Cognition and function predict a variety of adverse outcomes in a variety of settings in different historic eras.keywordS comprehensive geriatric assessment, disability, frailty, institutionalisation, mortality, risk index, risk score declaraTion of inTereSTS No conflict of interest declared.

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Section: Discussionmentioning

confidence: 99%

Validity of an early risk score for older adults

John

Montgomery²

2014

J R Coll Physicians Edinb

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“…Stereotypical ideas about older people, such as their vulnerability and need for physical protection despite their experience of life (Amulree, 1948; Sheldon, 1948b: 103), dominated society and affected expectations of patients, their families, the government and professionals. Some perception of vulnerability could be useful; if an older person could not manage alone, family and friends might provide support, although that help might be rejected in the individual’s resolve to remain independent (Exton-Smith, 1952: 186). Belief within the medical profession in the 1950s that senility was ‘the natural degeneration common to all persons’ and ‘the form of mental disease peculiar to this period of life’ (Bristol Local Medical Committee, 1953: 33) reflected widely held attitudes which accepted passive and custodial care for mental illness in old age.…”

Section: Recognizing the Need: The First Steps In The 1940s And 1950smentioning

confidence: 99%

Psychiatrists, mental health provision and ‘senile dementia’ in England, 1940s–1979

Hilton

2015

Hist Psychiatry

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Until around 1979, 'confused' or mentally unwell people over 65 years of age tended to be labelled as having 'senile dementia'. Senile dementia was usually regarded as a single, inevitably hopeless condition, despite gradually accumulating clinical and pathological evidence to the contrary. Specific psychiatric services for mental illness in older people began to emerge in the 1950s, but by 1969 there were fewer than 10 dedicated services nationally. During the 1970s, 'old age psychiatrists' established local services and campaigned nationally for them. By 1979, about 100 old age psychiatrists were leading multi-disciplinary teams in half the health districts in England. This paper explores the tortuous development of these new services, focusing on provision for people with dementia.

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“…Referrals for admission were frequently precipitated by illness or strain in the carer. 17 Home visits clarified the need for admission – indeed one-fifth of the patients need not be admitted because they could be managed at home, thus saving hospital beds. 18 Three months after returning home, half of the patients had maintained their improvement.…”

Section: Exton-smith As a Geriatricianmentioning

confidence: 99%

Professor Arthur Norman Exton-Smith CBE MA MD FRCP (1920–90): distinguished Geriatrician and Gerontologist

Denham¹

2009

J Med Biogr

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Professor Norman Exton-Smith was a highly respected, distinguished postwar consultant geriatrician with a worldwide reputation. He devoted his life to improving the medical care of elderly people and researching age-related decline in physical function, particularly thermoregulation and postural balance. He established thriving clinical and research departments at St Pancras Hospital, London. Many of his junior medical staff became well-known geriatricians. He published and lectured extensively, organized many meetings and conferences, and was advisor to the Department of Health and Social Security for many years. He was a valued authority on geriatric medicine within the Royal College of Physicians of London and a major influence in the British Geriatrics Society (BGS) of which he was Secretary and later the President.

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Investigation of the Aged Sick in Their Homes

Cited by 10 publications

References 3 publications

Validity of an early risk score for older adults

Validity of an early risk score for older adults

Psychiatrists, mental health provision and ‘senile dementia’ in England, 1940s–1979

Professor Arthur Norman Exton-Smith CBE MA MD FRCP (1920–90): distinguished Geriatrician and Gerontologist

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