Healthy ageing.

BACKGROUND: The increasing number of people reaching their 80s and 90s has triggered multidisciplinary consideration of how to address and capitalise on the longevity phenomenon. OBJECTIVE: The aim of this article is to provide an overview of ways in which clinicians can work with older patients to optimise their health and wellbeing during the later years of life. DISCUSSION: Old age need not be burdensome to individuals or society. There is strong evidence to support the management of many chronic diseases presenting in - or extending into - old age. General practice will need to adapt to the demographic challenges of an ageing population by targeting conditions that impede people from contributing to family and societal life. General practitioners (GPs) will also need to adapt to the changing expectations of, and from, older patients across the upcoming generations.

The effect of holiday haemodialysis treatments on patient mood, adverse symptoms and subjective wellbeing using the Big Red Kidney Bus.

BACKGROUND AND AIMS: People with end-stage kidney disease receiving haemodialysis are restricted to holidays where dialysis services are readily available. Holiday dialysis in regional, rural and remote areas is particularly challenging. The aims of this study were to evaluate the wellbeing of those who received dialysis in a holiday haemodialysis bus and to measure patient well-being with that of a comparable cohort of haemodialysis patients. METHODS: A three machine haemodialysis bus, the Big Red Kidney Bus, was built to enable people, their families and carers to take holidays across a range of tourist destinations in Victoria, Australia. Measures included pre-post subjective well-being, dialysis symptoms and mood questionnaires complemented by post semi-structured telephone interviews. RESULTS: Participating holidaymakers were positive about the haemodialysis bus service and the standard of care experienced. They reported decreased dialysis side effects of fatigue, muscle cramp and dry skin. The overall number of reported symptoms decreased, and the perceived level of bother associated with symptoms also decreased. No changes in subjective well-being and mood were detected. Mean Personal Wellbeing Index scores were significantly higher than in a comparative haemodialysis sample. CONCLUSION: The Big Red Kidney Bus provided a safe and feasible holiday dialysis service. Holidaymakers' well-being was reflected by the decreased dialysis patient side effects.