Reichel's Care of the Elderly: Clinical Aspects of Aging

Citation

Jones, S. (2011), "Reichel's Care of the Elderly: Clinical Aspects of Aging", Quality in Ageing and Older Adults, Vol. 12 No. 3, pp. 190-191. https://doi.org/10.1108/qaoa.2011.12.3.190.2

Reichel's series of geriatric textbooks is into its sixth edition and fourth decade and, at least on the western side of the Atlantic has achieved the status of an institution in the field of geriatrics. The internet, however, offering the accessibility of vast online academic databases has increasingly marginalised the role of textbooks in medical education. In the face of this, exhaustive reference works in medical specialties sometimes seem like exercises in quixotic pedantry. To avoid the fate of ending up as a dusty, weighty bookend, a textbook must offer not only a trusted registry of information; it should engage and inspire the reader and aim to capture the very essence of the subject.

In this sense, Reichel's text has undoubtedly succeeded. His first chapter is an eloquent distillation of the geriatrician's art; an inspiring polemic describing a role that extends well beyond that of simple physiological modulator. Contributions from diverse specialties as nursing, podiatry, dentistry and social work reflect the unavoidably multidisciplinary nature of good geriatric care. A frank and pragmatic chapter on sexuality in the elderly is a refreshing antidote to the rather squeamish attitudes to geriatric sexuality, which still exist today. Similarly, chapters covering topics such as driving in the elderly, elder abuse and retirement reinforce the textbook's humane and holistic approach to geriatrics.

This multi‐authored textbook is divided into small systems‐based chapters written by contributors who are specialists in that field. The essential focus on good geriatric care is preserved throughout, however. The writing style is also even and uniformly engaging and accessible. References are relevant and appropriate without clumsy over‐referencing. Illustrations are in greyscale format although a separate duplicate colour section is provided. Although this practice is not unusual in textbooks, some readers may find being referred on to the colour plate section from an uninterpretable dermatology photo rather tiresome.

At 637 pages, Reichel's care of the elderly is a relative welterweight in comparison with other textbooks. Consequently, its somewhat breathless canter through what is an inherently broad discipline sometimes comes at the expense of depth. As a trainee, currently specialising in movement disorders, I was rather disappointed to find only a cursory discussion of the “Parkinson's plus” conditions multiple system atrophy and progressive supranuclear palsy, two enormously complex and fascinating conditions. I suspect that these academic amuse‐bouches might leave the reader hoping to gain a deeper understanding of a particular subspecialty slightly dissatisfied.

The chapter on driving in the elderly is allocated more space than that on stroke management. One could argue that driving possibly has more relevance to the elderly populace than stroke management. Devoting twice as much space to the elderly with developmental disabilities than to hypertension management is possibly harder to justify. In such a patient‐centred and practical geriatric textbook, I was also surprised at the absence of an integrated section on the investigation and management of syncope. “Syncopal episodes” has only one page reference in the index.

Reichel's is an American textbook. Its contributors are all based in the states and epidemiological data is garnered almost exclusively from the US sources. Should this deter the UK reader? Occasional use of unfamiliar units should discourage only the most impatient and the specifics of disease management generally remain pertinent on this side of the Atlantic. Apart from offering an interesting counterpoint to the UK practices, however, I felt discussions of the US health and social care models were largely redundant as were coverage of issues such as elder abuse without reference to protection of vulnerable adults orders or driving and Driver and Vehicle Licensing Agency regulations.

I enjoyed using this textbook. It is well written, accessible and engaging. Its humane and holistic approach to the field of geriatrics is unquestioned and those considering a career in the field would be well served reading it. For those seeking an exhaustive reference work to serve as a basis for academic study in geriatric care, however, readers may be tempted to look elsewhere.