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The article discusses the COVID-19 outbreak has placed immense pressure on national healthcare systems globally, to increase bed capacity, protect healthcare workers and care for vulnerable groups. Topics include older adults face barriers to the adoption of telehealth services such as cost, trust of technology, design aod user interface challenges; and the COVID-19 pandemic has in fact led to greater uptake of telehealth services for older adults.

Background: Gastric tumors become increasingly prevalent with advanced age but can be challenging to diagnose in older adults who may present with non-specific symptoms. Here, we report a rare case of an occult gastric tumor associated with mesenteric panniculitis that presented with recurrent falls precipitated by vertigo.Case Presentation: We describe a diagnostically challenging case of cryptogenic gastric tumor associated with mesenteric panniculitis in a 74-year-old female who presented with abdominal bloating and recurrent falls precipitated by vertigo, dehydration, acute kidney injury and electrolyte deficiencies, but had no alarm symptoms. Her symptoms resolved after laparoscopic wedge resection of the gastric tumor.Conclusions: Our case highlights that while alarm symptoms such as dysphagia, weight loss, gastrointestinal bleeding and vomiting are considered indications for endoscopy, clinicians should also maintain a high index of suspicion for gastric tumors in older patients who may present with atypical symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Hip fracture is a global health issue, with significant morbidity and ongoing longterm care costs. Since 2016, care-coordinators (CC, nurses who support discharge into the community) from National University Hospital (NUH) and St Luke's Hospital (SLH), with therapists, integrated their work processes to provide holistic patient support. NUH CCs would review the patient's premorbid function, social support, and caregiver stress scores while in NUH. This information is shared with SLH's CC and therapists, who continue to follow up on patients to 100 days post-discharge and intervene as needed. We conducted a 9-month retrospective review on 34 hip fracture patients who were admitted to NUH, then SLH and back into the community. Results: The mean age was 79. 64.7% (22) were female. 1.3% (4) were known to have dementia. 11 of 34 (32.4%) had an AMT ≤7. The mean Charlson Comorbidity Index was 4.4. 97.1% (33) had surgery, and were allowed to full weight-bear. Mean length of stay in NUH and SLH were 8.47 and 35.6 days respectively. Mean premorbid MBI was 93.3. Mean post-fracture MBI improved from 57.1 to 80.2 at 100 days. Number of caregivers with Zarit >8 decreased from 3 to 2 at 100 days. 79.4% (27) patients were independent pre-fracture. At 100 days, 32.4% (11) patients were independent. Of which, 29.4% (10) were cared for by a domestic helper and 26.5% (9) by family. 1 patient went to a nursing home. 2 patients were admitted to an acute hospital, and 1 died. Discussions, conclusions: There was good functional recovery and reduction of caregiver stress from the acute setting to rehabilitation to home (100-days). There was loss of functional independence post hip fracture, resulting in a need for a caregiver. In Singapore's context, this was a domestic helper or a family member. [ABSTRACT FROM AUTHOR]

We report the case of an older lady who was admitted to a tertiary teaching hospital with sub-acute functional decline of two months' duration, which was initially attributed to a concomitant urinary tract infection. Further investigations, however, revealed the diagnosis of pituitary apoplexy with central hypocortisolism. Subsequent treatment with physiological doses of steroids improved patient's function and overall well-being. This report adds to the sparse literature on pituitary apoplexy in the older adults and emphasizes the non-specific presentation of this clinical syndrome. [ABSTRACT FROM AUTHOR]

The article presents the case of an 83-year-old male with diabetes mellitus and chronic kidney disease who was presented with left ear pain for two weeks to discuss cephalosporin (Cefepime)-related neurotoxicity. Based on magnetic resonance imaging, he has malignant otitis externa and was prescribed cefepime. He developed hyperactive delirium and his treatment was changed to meropenem. Also mentioned are the manifestations of Cefepime-related neurotoxicity like myoclonus aphasia.