Leading experts in frailty launch the Silver Book II in collaboration with the British Geriatrics Society

22 February 2021

The Silver Book II, written by leading international experts in frailty and hosted by the British Geriatrics Society, addresses a wide range of urgent care issues specific to older people. Aimed at clinicians and other healthcare professionals working in emergency departments and urgent care, this updated resource is presented in a highly accessible digital format and is free of charge.

Since the original Silver Book was published in 2012, the demographic predictions for global ageing have continued unabated, and almost all health and social care professionals now encounter older people living with differing levels of frailty, on a daily basis. Older people have a higher prevalence of multiple conditions, including dementia and disability, and evidence shows that they are admitted to hospital more frequently, have longer stays and occupy more bed days in acute hospitals, compared to other patient groups. The COVID-19 pandemic has further complicated this picture and exponentially increased the need for high quality urgent care for older people. 

The Silver Book II addresses the specific needs of older people in the first 72 hours of an urgent care episode. It aims to:

•    Help healthcare professionals understand the issues relating to older people accessing urgent and emergency care in the first 72 hours irrespective of geographical setting and provider group
•    Describe the challenges of health and social care for older people at the interface between primary and secondary care, and pre-hospital and in-hospital care
•    Outline best practice in urgent care for older people
•    Improve satisfaction and outcomes for older people and their families and carers in urgent care
•    Improve satisfaction and delivery of care by staff.

The Silver Book II aims to give healthcare professionals working in urgent care the knowledge to recognise and effectively treat non-specific presentations. It provides best practice in the management of delirium, falls, ‘silver trauma’, continence and skin integrity. Other important, but often overlooked, topics covered in the publication include mood disorders, substance misuse and ‘elder abuse’. For many older people with severe frailty and urgent care needs, the end of life phase can be measured in months rather than years, so being able to identify this transition, and adapt from curative to palliative approaches is also addressed.

It is encouraging that health and social care professionals’ understanding of caring for older people has increased substantially in recent years, and concepts associated with frailty have become increasingly mainstream. The Silver Book II aims to bridge remaining gaps in knowledge and to promote key areas of best practice for a global health and care audience. 

Professor Simon Conroy, Professor Chris Carpenter and Professor Jay Banerjee led the development of the publication with contributions from leading experts in a number of countries including the Netherlands, Israel, Poland, Sweden, Switzerland, Spain, Taiwan, Vietnam, the United States and the United Kingdom. 

Simon Conroy, Professor of Geriatric Medicine at the University of Leicester and co-lead author of the Silver Book II, commented:

We are delighted to see the Silver Book II launched. Written by clinicians for clinicians, we hope this resource will be of help and perhaps some inspiration to colleagues supporting the care of older people with urgent care needs across the world.”

Dr Jennifer Burns, President of the British Geriatrics Society, commented: 

We are delighted to launch the Silver Book II in collaboration with leading experts in the field of frailty. While this free-to-access online resource will be of particular interest to those working in emergency medicine and urgent care, all healthcare professionals caring for older people will find it relevant. The COVID-19 pandemic has only served to reinforce the ongoing need for high-quality care for older people. I commend this excellent guide to best practice in urgent care and encourage all doctors, nurses and allied health professionals to read it via the BGS website and use it to inform their care for older people.”

View the Silver Book II here. When sharing this resource via social media please use the hashtag #SilverBook2