In this book I mention the patient who first inspired me to become a psychiatrist. He was an elderly gentleman admitted to a vascular ward for an elective repair of his aortic aneurysm. He came to hospital alone, dressed in a tweed suit and holding a remarkably handsome and incredibly dilapidated brown leather suitcase. During his inpatient stay he told me about this suitcase; from the first time he had ever packed it as he left his home as a child evacuee in the Second World War, to this admission into hospital, where he received a new and unexpected diagnosis of bowel cancer and faced the realization that his life was coming to an end. Despite this diagnosis, he remained positive and stoic and regaled the ward with anecdotes which captured the richness of his life. I thought of this gentleman frequently as I edited this book as both reminded me that psychiatry is the profession for me.

Our hope is that this book inspires readers in a similar way and there are two particular reasons it might be successful in doing so. First, it is a collection of articles previously published in Advances in Psychiatric Treatment (now called BJPsych Advances). Many of you will be familiar with Advances papers and recognize why a collection of their articles relevant to old age psychiatry will be stimulating and interesting. Without being exhaustive systematic reviews, which (although scientifically robust) can be a little dry, Advances papers tend to provide easily accessible, refreshing and comprehensive overviews of pertinent topics to a subject area. And they can provide perspectives on topics not usually encountered in major textbooks: in Clinical Topics in Old Age Psychiatry we have everything from discussion of ethical issues in relation to biomarkers in Alzheimer’s to mention of the idea of dwelling as relevant to thinking about residence capacity; from mental health issues in Parkinson’s disease to a practical guide for home assessments; from discussion of the notion of ‘recovery’ in dementia to the relevance of Heidegger and Wittgenstein.

Secondly, there is the breadth of experience which has been captured – from the authors who are medical students, to trainees, consultants and eminent professors to the editors themselves. I am a psychiatry registrar, just embarking into the field. Julian C Hughes is a recently retired professor of old age psychiatry with an exceptionally distinguished career behind him. We feel these mixtures gives the book a refreshing touch. It includes chapters written by clinicians and trainees who know their field inside out and are expert at communicating the uncertainties and joys of working in old age psychiatry. It also includes chapters written by international experts which are highly informative and practice-changing.  

When the gentleman I described left the ward with his trusty suitcase he told me to concentrate on adding ‘life to years, not years to life’. Both he and this book spark my imagination and capture what I believe is the value, wisdom and thoughtfulness of old age psychiatry.

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