Older People, Pain and Palliative Care
Balance acute diagnosis, frailty, function, symptom relief, treatment burden and patient goals in complex presentations.
How to prepare for FRCEM SBA
Protect the full Emergency Medicine curriculum, prioritise the published item counts and practise the decisions expected of a clinician approaching independent practice.
Core concepts
Concept 1
Combine physiology with baseline cognition, function, frailty, medicines, support, reversibility and recorded preferences.
Exam cue: Do not attribute delirium, falls, pain or deterioration to age or terminal illness until reversible threats and symptom needs are assessed.
Concept 2
Relieve symptoms, rationalise medicines, prevent avoidable harm and coordinate geriatric, community, specialty and palliative support.
Exam cue: Choose proportionate tests that can alter treatment, disposition or comfort, informed by capacity and shared goals.
Risk pitfalls and guardrails
Using frailty or a palliative label as a reason to omit assessment, analgesia or a patient-centred discussion of reversible treatment.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Choosing an answer that is generally true but does not fit the patient's physiology, urgency, evidence or current decision point.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Memory anchors
What frames decisions in older people, pain and palliative care?
Combine physiology with baseline cognition, function, frailty, medicines, support, reversibility and recorded preferences.
Which older people, pain and palliative care findings change urgency?
Do not attribute delirium, falls, pain or deterioration to age or terminal illness until reversible threats and symptom needs are assessed.
How should investigation be planned in older people, pain and palliative care?
Choose proportionate tests that can alter treatment, disposition or comfort, informed by capacity and shared goals.
What makes management complete in older people, pain and palliative care?
Relieve symptoms, rationalise medicines, prevent avoidable harm and coordinate geriatric, community, specialty and palliative support.
What common error should be avoided in older people, pain and palliative care?
Using frailty or a palliative label as a reason to omit assessment, analgesia or a patient-centred discussion of reversible treatment.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
An 84-year-old man with dementia presents with new agitation. Staff report that he is usually calm. He has suprapubic tenderness and has not passed urine for 12 hours. Which first step best addresses the likely cause?
An 86-year-old woman with frailty presents after a fall. She is taking apixaban and cannot recall the event. Examination is normal apart from a scalp bruise. What is the most appropriate head-injury approach?
Answer all questions to submit.
Next step personalized recommendations
Continue learning
Move forward only after this module is stable.
What is Pass Harbor?
Completely free exam prep for 247 UK exams.
- Practice questions
- Flashcards
- Study guides
- Mock exams
- No registration
- No paywall
- Start instantly
“No more expensive exam prep. Quality study tools should be accessible to everyone.”