Early research published though suggests there is no benefit even when used in addition to taking supplements. Companies have been trying to promote these machines to the general public, so buyer beware. Read more in the Annals of Internal Medicine.

Some hospitals now use a comprehensive assessment of elderly patients which looks at all the medical issues, social needs and mobility problems of the individual. The patient should be on a ward dedicated to the assessment and rehabilitation of the elderly for the benefits of this approach to be maximised, and not a general medical ward with a specialist team popping in. Having the specialist staff working together all the time brings consistency of care, greater expertise and opportunities for sharing best practice. Communication with families is also improved.

So if you or an elderly family member is suddenly admitted to hospital may we suggest you find out if the hospital has a geriatric assessment and rehabilitation ward. Ask for a bed there. It may mean the difference between going home and going into a home.

The research paper can be read in the British Medical Journal .

I wonder though if it gives out some mixed messages to the public. If health professionals don't see the merit in having a flu vaccination without such an incentive does it undermine the message they try to tell others?  Sadly at the Trust concerned a member of staff died from flu last year. Surely that would have been a powerful motivator for many.  

The Trust says that the number of days saved, that would likely have been lost to ill-health, makes giving one day off a sound business decision. It is unlikely that private firms will feel able to offer such an incentive. I would be interested if you know of one that is doing so.

The details of the case in brief are that M fell unexpectedly into a coma in February 2003. Viral encephalitis left her with permanent brain damage and in a vegetative state. In 2007, with the support of her doctors, M's family applied to have artificial feeding stopped. Tests were carried out and it was concluded that M was not in a persistent vegetative state but a state of minimal consciousness. In due course and after exploring more treatments, the family decided that continuing with the application would be what M would want.

Mr Justice Baker accepted that M had expressed verbally what her preferences would be and took them into account. However, he states such expressions did not carry substantial weight. He is clear though that if there had been a formal advance decision that would have been binding.

The application by the family was rejected and artificial feeding will continue. There seems little prospect of M's level of consciousness improving, according to the doctors, but it cannot be said there is no prospect of her quality of life improving.

When you tell your family your preferences, whatever they may be, make sure you give them a copy of your living will.

Read the judgment  of Mr Justice Baker in full.

Researchers found that when clinicians were asked to come to an agreement on 'how long?' this was likely to be more accurate. They also found some tests eg blood tests used in conjunction with a doctor's opinion resulted in a more accurate estimation.

Patients in the study had incurable cancer and were no longer receiving active treatment. More information on the diagnostic tools used can be found in the August edition of the British Medical Journal.

• make your living will while you can
• remember to periodically review it
• a living will only applies when you cannot communicate in any other way
• make sure people know you've done one

Respect Our Wishes has advocated all of these for a long time.

Bereavement is a desperately sad time for anyone. If services can be better adapted to clients it can only be good news. You can read about moves towards separate sessions for men and women in the USA in this article from the New York Times.

Would you feel more comfortable in an all male or all female group? Or doesn't it matter? If you can recommend a bereavement support group please comment below.

For more information about organ donation see our FAQs page. To read about why this change has been implemented go to the directgov website. 

Importantly the guidance states clearly that pain relief should addressed immediately and management of pain should be a constant element of care. It also advocates a multi-disciplinary approach in care teams as falls leading to fractures are often caused by other conditions.

Visit the NICE website to learn more.

There has been criticism it does not address the spiritual side of people's last days. The Statement of Last Wishes  which you may create on this website offers that opportunity.

The seven pledges of the charter can be viewed on the RCGP website

Reductions in cholesterol and blood pressure were significant over the 3 months. It is estimated many heart attacks and strokes could be avoided by taking such a pill. This is especially the case in less developed countries where preventative measures are used less frequently. The four drugs combined within the polypill were

• aspirin
• simvastatin
• hydrochlorothiazide
• lisinopril

1 in 8 people experienced some side effects. 1 in 20 had to withdraw from the trial.

Read the research findings in detail at PLoS One

Nerve block was found to reduce levels of acute pain but the evidence is limited. Traction of the hip before the operation does not seem to offer any benefit. Other care such as non-steriodal anti-inflammatory drugs, use of TENS machine, relaxation techniques and physical therapy had been insuffuciently researched for a sound conclusion to be reached.

Read more in the Annals of Internal Medicine

The numbers of British people who have travelled to Switzerland remain very, very small. However, they have raised a lot of ethical questions as not all have had a terminal illness and one gentleman in particular was a young adult.

For comments on both sides of this story from Swiss nationals please see this BBC article

Research into the end of life of dementia patients found that when the health care proxy believed the patient had less than 6 months to live there were fewer hospitalisations and treatments such as tube feeding. However, 80% of health care proxies did not appreciate when their loved one had less than six months to live. This ties with the figure that only 18% of proxies had been given information on the patient's prognosis by a doctor.

More can be read on this research from the USA in the New England Journal of Medicine.

One small part of the administrative process though seemed to cause all of them disproportionate stress and worry. Having had their scans, they were told on the way out 'if it's serious we'll call you in a week, if it's not we won't'.

There are two points in particular that I would like to see addressed. Firstly why on earth, when somebody's just had a brain scan would you remind them of the bad case scenario as they are trying to pull themselves together? How about a neutral 'we'll let you know your result / when your next appointment will be within ten days'?

Secondly, not one of them seemed clear what would happen next if they didn't get a call in one week. This compounded the fact that these rational, intelligent people didn't really know whether a week meant exactly a week or to give it until ten days, to assume the hospital wouldn't leave a message on an answerphone so had they missed a call, would the hospital call at all if not serious...? Turns out the answer to that is only months (literally) later.

Would it really be such a huge burden to commit to telephoning everyone? All my three friends ended up going to see their GPs to find out what would happen next. So the NHS just took a hit elsewhere. None of these three are elderly nor live alone. Can you imagine how much worse the worry must be if you do?

The wristband is useful for those times when you do not want to have your wallet or handbag on you. It is soft enough to wear comfortably in bed.

To see the new DNAR wristband click here

To read more about DNAR directives click here

Maximising the quantity and quality of life likely to result from the transplant is being put forward as a better rationale. Could this shift in emphasis to quantity of life result in a form of ageism in the NHS? Read what the associate medical director of NHS Bloods & Transplant  has to say.

The Royal College of Physicians is to fund a review starting next month of the care of such patients. At present if it is proposed treatment is to be withdrawn a court ruling must be sought. (See GMC guidance)

The first thing that made me pay more attention was the figure that 50% of these men would die before age 50. I was stunned - that's in the UK. Poor access to healthcare contributes hugely to this.

The second was an annual visit to the graves of teenage sons. They were clearly honouring their memory but this was not a not so much a moment of quiet reflection as tinged celebration. Cars were parked close by so music could be heard and plenty of drink was taken along. Many family members attended and this was a number of years on.

OK I confess to watching Big Fat Gypsy Weddings. It was thought provoking.

There are devices specifically designed to cut pills and you could ask your pharmacist about them. Researchers also recommend that drug companies make a greater variety of pills for more toxic medications to reduce the need for patients to cut pills. NHS Choices looks at the research.

Make the time to have a chat with an elderly neighbour this holiday. Yours may be the only face they see for a few days. Dying Matters is running a campaign called "Don't die alone & at home this Christmas" and we at Respect Our Wishes would like to add our voice.

Over 700 people took part in the trial in America. Some were given echinacea, some a placebo pill and some did not receive pills of any variety. Read more from the Annals of Internal Medicine.

Yet under the scheme the doctors would remain independent ie not employed by Sainsburys. Would being located in a building selling alcohol and tabacco really undermine a doctor's advice? Or would it be nice to go to a well-lit building with adequate car parking and possibly a frequent bus service?

This did not come out of the blue. Sainsburys has already piloted the idea in a few areas. Perhaps more interestingly, since the recent debate more doctors have apparently signed up.

What do you think? Would you have concerns if your GP started offering appointments within a supermarket? Or have you ever had your flu jab at a pharmacy or a supermarket?

The commissioners will consult experts, look at what happens in other countries and listen to a range of interested parties over a period of twelve months. Members of the public may also contribute views. Details of how to obtain a form or where to send a letter and who to telephone may be found by clicking here.

I have worked in a doctors surgery, doing my stint on reception when short-staffed, so would like to claim a little insight. The notion that an anonymous call centre could provide a similar level of service is, in my opinion, far fetched.

There are older and housebound patients whose only conversation that day may be with the receptionist. They appreciate a familiar voice and being known as an individual.There are the calls where you know when the gentleman says his wife is a bit off colour, given his habitual understatement, it merits a visit within an hour. It works the other way too, when staff are trying to persuade mum to bring her child in for a vaccination appointment.

The booking of appointments is referred to as "Back office GP services" ready for "radical re-engineering". I would counter that it is integral to frontline services. (If you need a key performance indicator, count the number of boxes of chocolates and biscuits given to Practice staff at Christmas.) Replace that insider knowledge with a computer algorithm and I predict a rise in complaints and probably near misses. Would quality of service count more if we used 'customer' instead of 'patient' or is it cost and only cost that matters?

Read the preface (on p9). The author's parents died this year and only 8 weeks apart. It is a moving account of two very different experiences. The authors suggest we should all talk more about how we would like to die:To improve existing services and the choices of care support available.

Read it here www.demos.co.uk Then maybe use it to start a conversation with loved ones.

"Dying for Change" by Charles Leadbetter & Jake Garber, Demos 2010

There are a number of recommendations around patients with more than one medical problem, nutrition, hypothermia and avoiding surgical complications. Improvement to the care of those who fall and fracture their neck of femur are suggested. Perhaps most importantly of all, they found that pain management was not good for many patients and this is avoidable.

You can read more from National Confidential Enquiry into Patient Outcome and Death.

The review also looks at services by type of provider ie council, third sector & private. Regional variations in services are also commented upon.

Commercialisation has brought skull and skeleton shaped sweets but it not a frivolous celebration. Most Mexicans believe in a cycle of birth, death and rebirth. It is a recognition that death is part of life. I've never been to Mexico but this sounds significantly more mature and meaningful than the trick or treat Halloween we had last night.

I know I'm bad at remembering, after the first year, the date when a friend has lost a parent. People rarely tell you though out of 'good manners'. Yet the anniversary of a death will never become just another day. Is just a moment of personal reflection sufficient? Do you do anything to celebrate the lives of loved ones who have died as the years go on?