Following the publication of the National Confidential Enquiry into Patient outcome and Death (NCEPOD) report An age old Problem 2011 and the Royal College of Surgeons (RCS) report Access all ages 2012, interest in the specialist area of perioperative medicine for the older surgical patient is gathering momentum. As a result, clinicians, commissioners and patients are recognising there is a need to have geriatrician input in surgical pathways for older people. Continue reading →
Dr Henk-Frans Kwint is A Care Community Pharmacist at Stevenshof Pharmacy affiliated with the SIR Institute for Pharmacy Practice and Policy.
A recent Dutch study on older patients receiving their drugs via a sophisticated dosing aid, called multidose drug dispensing, has shown a higher self-reported medication adherence compared to patients receiving manually-dispensed drugs, despite a lower knowledge and lower cognitive function among patients receiving these dosing aids. The research is published in Age and Ageing. Continue reading →
Sarah McGrory is a PhD Student at the Alzheimer Scotland Dementia Research Centre at the University of Edinburgh. She Tweets at @ alzscotdrc
Are some activities harder than others for people with dementia? In our research, recently reported in Age and Ageing, we looked at how people with dementia differed in their day to day activities. 202 people with mostly mild to moderate dementia in Scotland were asked about their activities
Activities (using the telephone, shopping, food preparation, housekeeping, laundry, travelling, taking medications, handling finances) can be measured using a questionnaire called the Lawton Instrumental Activities of Daily Living (IADL) scale. Usually scores on the individual tasks are added together to give a total score ranging from 0 to 8. This number can hide a lot of information about a patient’s functional ability. It assumes every functional activity is equally difficult, which is rarely the case. For example, being able to manage your finances is likely to be harder for most people than being able to eat. Continue reading →
Felicity Jones is a final year medical student at King’s College London and current Junior Members Representative for the BGS: representing Junior Doctors and Medical Students on the Trainees Council. She tweets personally at @faejones, and for BGS at @younggeris.
Caring for an ageing population is a major challenge of our time. Across the world, societies are ageing, with wide-ranging impacts. Many overlook the huge contributions the over-65s make to our labour workforce, running the third sector, and as carers for friends and relatives. It’s easy for these contributions to be ignored in a narrative which at a societal level tends to focus the challenges of providing a comprehensive health and social care to an ever-increasing proportion of our society. Continue reading →
There is a lot of criticism of how we manage cognitively impaired patients in acute hospitals. And advice on how to do it better. The hope has been that more expert and co-ordinated services would improve outcomes and save resources. But there has been little in the way of rigorous evaluation.
We developed a specialist medical and mental health unit with the ambitious objective of demonstrating best practice. We enhanced the ward environment, ward staffing and skill mix, including mental health specialist nurses, therapists and psychiatry, trained all staff to a high level in the person centred philosophy of care, and endeavoured to engage family carers more fully.
The BGS blog has recently hosted a lot of commentary about the Francis Report and its implications for the NHS, particularly in England. It can be useful, in times of reflection, to look outside of your immediate working environment to consider what can be learned from elsewhere. The Francis Report has implications for other healthcare economies.
Here Prof Des O’Neil considers its implications for care in the Republic of Ireland. This article initially appeared on the BMJ blog.
Across the Irish Sea, a new and unhappy phenomenon is arising for older people in a mixed private and public healthcare system. A somewhat messy and porous border separates the two systems, with public and private beds in public and voluntary hospitals, as well as exclusively private hospitals which provide elective care in the main. There is much less discussion within the profession than might be desirable about the impact of the system on professional practice, with the few studies available (from general practice) showing differing treatment patterns for public and private patients . The aspiration of the current government is for a system of universal coverage, based on the Dutch model, but few are holding their breath. Continue reading →
Professor Paul Knight is Director of Medical Education and a Consultant Geriatrician for the Elderly at the Royal Infirmary in Glasgow. He is also President of the British Geriatrics Society.
The Westminster Government’s response to the second Francis Report was published as I was preparing to go to Harrogate for the BGS biannual conference and co-incidentally where I was due to speak on what the BGS had done and would do “After Francis”. So it wasn’t until a few days later that I managed to read in detail “Hard Truths. The Journey to Putting Patients First”. Continue reading →
Matteo Cesari, MD, PhD is Chargé de Mission at the Gérontopôle of the Centre Hospitalier Universitaire de Toulouse, researcher at the INSERM UMR1027, and Professor at the Université de Toulouse III Paul Sabatier (Toulouse, France). He is Editor-in-Chief of the Journal of Frailty & Aging. He Tweets at @macesari
Our societies are ageing. The number of older people is steadily growing, threatening the sustainability of public services including healthcare. Age-related chronic and disabling conditions not only adversely influence older people’s quality of life, but also represent a burden for public health expenditures. It is a fact that something has to be done in order to prevent the (often irreversible) loss of physical function that occurs with advancing age. If we are to accomplish such an ambitious task, a major revision is needed in our approach to older people and, consequently, in the concept of geriatric medicine. Continue reading →
Michael Alcorn is aGeriatric and General (Internal) Medicine Specialty Registrar at the Southern General Hospital, Glasgow and Honorary Clinical Teacher at the University of Glasgow Medical School. You can view the poster of Dr Alcorn and team at this week’s BGS Scientific Conference, at exhibition space 66.
In common with other UK doctors in training, I have been taught in many different environments by many different teachers with differing understandings of what it means to teach and to be taught. Continue reading →
This week sees the 2013 BGS Autumn Scientific Meeting take place in Harrogate. This international multi-disciplinary conference is for professionals concerned with the the health and care of older people. We will be presenting a packed scientific programme, with updates on a variety of clinical topics covering several special interests.
The third day of our conference opens with two parallel sessions (9.00-10.30):
Session Q: Bereavement: Beginning with Prof David Jolley (University of Manchester) on psychiatric disorders after bereavement. Next is Mr Alan Casseden (Cruse Bereavement Care) on who will be encouraging attendees to reflect on their own death. Finally Dr Peter Dean (Coroners Office) describes changes in the coroner’s jurisdiction.
Session R: Care Homes: Dr Clive Bowman (City University, London) begins with a presentation entitled: “Care Home Medicine: Outside the box but not at large.” Dr Adam Gordon (Nottingham) will discusses “Comprehensive Geriatric Assessment in care homes”, and Ms Julie Whitney (Kings College Hospital) will speak about on falls prevention in Care Homes. Continue reading →