When it is four conditions, nine tablets and nobody joining it up.

What we look after

• Medication review: bring every tablet, including herbal preparations and anything bought from a chemist. Older people are frequently on medicines nobody has reviewed in years, some of which are now doing harm.
• Blood pressure, diabetes, cholesterol and stroke prevention: with targets appropriate to age, which are not the same as at forty.
• Falls: why they are happening, and what can be changed. A fall is a medical event, not clumsiness.
• Memory and confusion: and distinguishing dementia from the many treatable things that imitate it.
• Joints and mobility: arthritis, pain control and physiotherapy.
• Eyes and hearing: both of which cause falls, isolation and apparent confusion when uncorrected.
• Continence. Very common, very rarely mentioned, and often improvable.
• Weight loss and appetite.
• Prostate and urinary symptoms.
• Bone health after a fracture.
• Immunisation: see the full list.
• Support for the family doing the caring, which matters more than anyone admits.

Bring the bag

The single most useful thing you can do for an older relative's appointment is put every medicine in the house into a bag and bring it. Not a list — the actual packets. Include:

• Everything prescribed, by anyone, anywhere.
• Anything bought over the counter, including painkillers.
• Herbal mixtures, roots, teas and supplements.
• Anything a relative brought back from abroad.
• Things they stopped taking but kept.

We find duplicates, interactions and medicines being taken at the wrong dose in a large share of these appointments. Stopping the wrong tablet can transform someone more than starting a right one.

Bring them in if you have noticed any of this

• They have fallen, or nearly fallen, in the last six months.
• They are more forgetful, more confused, or have changed in personality.
• They are losing weight or have lost interest in food.
• They are more withdrawn or have stopped going out.
• They are dizzy when standing up.
• They are taking more than five medicines.
• They have pain that is limiting what they do.
• They are struggling to wash, dress or manage stairs.
• They have been in hospital recently and nobody has reviewed things since.
• You, the person caring, are exhausted.

Confusion that comes on suddenly is an emergency

This is the single most important thing on this page. An older person who becomes confused over hours or a day or two, more muddled than usual, seeing things, drowsy, or agitated, is not "just getting old". That is delirium, and it is usually caused by something treatable: a urine infection, chest infection, dehydration, constipation, pain, or a medicine. It needs seeing the same day.

Dementia comes on over months and years. Delirium comes on over hours and days. The difference is the whole diagnosis.

What it costs

Full list on the health checks page.

Common questions