An evaluation of palliative care in the acute geriatric setting

PU: Impact of urinary incontinence after stroke: results from a prospective population-based stroke register. Post-stroke urinary incontinence: One-year outcome and relationships with measures of attentiveness. Post-stroke urinary incontinence with impaired awareness of the need to void: clinical and urodynamic features. Donnan GA, et al. Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort. van Zandvoort MJ, van der Worp HB, et al. Early cognitive impairment predicts long-term depressive symptoms and quality of life after stroke. Delayed increase in infarct volume after cerebral ischemia: correlations with thrombolytic treatment and clinical outcome. A new rating scale for age-related white matter changes applicable to MRI and Acute cerebrovascular accident and lower urinary tract dysfunction: a prospective correlation of the site of brain injury with urodynamic findings. Urinary function in elderly people with and without leukoaraiosis: relation to cognitive and gait function. Impact of white matter changes on clinical manifestation of Alzheimer's disease: A quantitative study. SIR—Improved medical practice and therapeutics, combined with public health measures, have contributed to significant demographic change. Increases in the proportion of elderly individuals are already apparent, a trend predicted to continue over the next 20 years [1]. These factors have prompted changes in patterns of disease, with increasing numbers of people dying of 'end-stage' chronic diseases such as heart failure, cerebrovascular and respiratory diseases , as well as cancer [2]. Dementia prevalence is also increasing, with estimates suggesting that ∼1.8 million people in the United States alone have advanced disease and may ultimately require palliative care [3]. Despite these statistics, evidence suggests that hospice care remains predominantly focussed towards malignant diseases [4, 5], and that older people tend to have reduced access to high-quality palliative care [6]. One approach to improving palliative care was development of the Liverpool Care Pathway (LCP). This document, well established for malignant disease, outlines goals for 327