Every older person in a care home needs access to high quality healthcare

chg-v2The British Geriatrics Society (BGS) calls for everyone who commissions or provides healthcare in care homes to follow the principles of good practice set out in the guidance we are publishing today, so that every older person who lives in a care home in the UK has access to high quality healthcare which fully meets their needs. Based on the clinical expertise of our members our updated guidance sets out clinical and service priorities for how best practice can be achieved, and provides clear indicators of what successful delivery looks like for older people, their families and carers.

In the UK 405,000 people over the age of 65 years old currently live in care homes. This represents 16% of older people over the age of 85. Their healthcare needs are complex and the average care home resident has multiple long-term conditions, and frailty. They are likely to have better health outcomes if health services reflect these needs, and they have access to comprehensive, multidisciplinary assessment, with input from healthcare specialists trained in the care of complex medical problems in later life. Continue reading

Hypertension and dementia: exploring the evidence

Jenni Harrison is a Clinical Research Fellow at The University of Edinburgh. Her previous role was as an Academic Clinical Fellow in Geriatric Medicine in Leicester. She was part of the Hypertension in Dementia (HIND) Research Group at the Universities of Nottingham and Leicester. The group recently produced a New Horizons article on the management of hypertension in people with dementia. She tweets @JenniKHarrison.

deerIn the face of uncertainty around the optimal management of hypertension in people with dementia we sought to review and summarise the available evidence. After first considering the rationale for the treatment of hypertension and possible reasons why the approach could be different for those with dementia, we structured our review around three key questions:

(1) Do people with dementia experience greater adverse effects from antihypertensive medications?

(2) Is cognitive function protected or worsened by controlling blood pressure?

(3) Are there subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful? Continue reading

Multi-morbidity – the case for change

David Paynton is a GP in an inner city surgery. He is also the Clinical Lead for Commissioning for the RCGP.

Dr David Paynton

Generalists are the solution.

For too long policy makers have ignored what clinicians on the front line have been telling them, people with multiple conditions not only exist but are the mainstream.

It is our failure to recognise this fact that has put pressure in the system as the NHS struggles to keep its head above water especially when one adds social factors, depression and mental health into the mix of complexity.

The RCGP “responding to the needs of patient with multi-morbidity” has created a powerful case for change with the need to substitute ever-increasing investment into super specialism by a call for the generalist to support those with multi-morbidity in the community. Continue reading

An overview of the Policy Forum for Wales event

Hospital in Bridgend, Wales. He is a care of the elderly physician with an interest in Parkinson’s Disease and movement disorders.
flag_of_wales_2-svgOrganised by the Policy Forum for Wales, this event which was held on 19 October, provided the Welsh Government, and other agencies, the opportunity to engage with key stakeholders and discuss public health policy issues that particularly affect Wales. This seminar was about involving health and social care senior policy makers in developing a vision for Wales and bringing together multiple organisations (public sector, voluntary and third sector) to have a dialogue about how best to influence the Welsh Government’s health and social care policies.

The day was kicked off by chair Mr Huw Irranca – Davies AM, with a cross party group on cancer introducing the theme of the day. This was followed by brief from Professor Siobhan McClelland on current trends in health care in Wales including a £700 million gap in the budget for health and social care (10% of the total health budget). She emphasised that service configurations should be decided according to local need rather than by committee or Government mandate. Continue reading

Planning for our new BGS website… Have your say!

survey-2Calling all BGS Members and friends! We are inviting you to complete this survey to help us find out more about what our members, and other visitors, are looking for from the new BGS website which will replace the current main BGS site.

This survey should take no longer than 5 – 10 minutes to complete, depending in the length of your answers. This survey also provides the opportunity to join the Website Consultation Group and/or volunteer to review and update existing materials from the current site. Continue reading

Incoming President of the BGS calls for respect for ‘victims of underfunding’

eileenDr Eileen Burns, who takes office today as the new President of the British Geriatrics Society, has called for public recognition that older people facing delays in discharge from hospital are the victims of underfunding of social care and not ‘the problem’. Dr Burns is urging members of the public, and media, to reject pejorative terms like ‘bed blockers’ and urge the Government to give social care the priority it deserves.

Dr Burns is only the second female President since the Society was founded in 1947. She has been a consultant geriatrician in Leeds for twenty-two years, and is an expert in community geriatrics. The primary focus of community geriatrics is to reduce admissions to hospital, and prevent delayed discharges and re-admissions, by ensuring that older patients receive adequate and appropriate care within their community.

Accessible social care is a key factor in reducing hospital admissions and delayed discharges for older people. According to research published earlier this month by Age UK, the number of older people in England who don’t get the social care they need has soared to a new high of 1.2 million – up by a staggering 48% since 2010. Continue reading

BGS raising the profile of Sarcopenia and Frailty in older people

1025_atrophySarcopenia, the loss of skeletal muscle mass and function that accompanies ageing, has emerged as a key topic in geriatric medicine and represents a rapidly expanding field of research. Prevalence may be as high as 1 in 3 for frail older people living in care homes. There is increasing appreciation of sarcopenia’s importance for an ageing population and a growing understanding of its causes. The condition is closely linked to physical frailty and detection of sarcopenia is beginning to be incorporated into clinical practice, and to undergo large clinical trials.

To better represent this area the British Geriatrics Society has announced the formation of a new Special Interest Group (SIG) focusing on sarcopenia and frailty research.

In addition, to help raise the profile and aid the recognition of sarcopenia, a dedicated session covering diagnosis and treatment of the disease is being held at the BGS Autumn Meeting in Glasgow. Continue reading

Joining up care for older people with frailty

Across the UK, innovative collaborations between GPs and specialist geriatricians are paving the way to better care for older people with frailty

rcgp-bgd-coverA new joint report from the Royal College of GPs and the British Geriatrics Society has been published today, showcasing how GPs and geriatricians are collaborating to design and lead innovative schemes to improve the provision of integrated care for older people with frailty.

Advancements in medicine are a great success story, and as a result our patients are living longer, but they are also increasingly living with multiple, long term conditions and that brings a number of challenges for general practice and the wider NHS.

Older patients make up the majority of those attending GP surgeries and acute hospitals so getting the right combinations of care in the right place and at the right time is crucial to avert avoidable admissions and delayed discharge from hospital. Continue reading

Getting to grips with multimorbidity and polypharmacy for older people

Dr Kevin Mc Namara is a Senior Research Fellow at Deakin University’s School of Medicine and Centre for Population Health Research. He has a particularly interest in the implementation of models for chronic disease prevention and management, including the management of multimorbidity. His paper, Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia, has been published in Age and Ageing journal.

aaResearchers from Australia offer some valuable insights about effective multidisciplinary care for older people who often have multiple health conditions (multimorbidity) and take multiple medications (polypharmacy). In ageing populations across the developed world, multimorbidity and polypharmacy pose unique and growing challenges for health professionals and systems. Treatments and goals for different health conditions are often not compatible, guideline recommendations may not be feasible, the evidence often lacking for older adults, and health systems are not designed to coordinate the activities of multiple health professionals often involved with care. Continue reading

A Connection between Cognitive Decline and Metabolic Disease May Vary by Sex and Ethnicity

Nancy West, PhD is an Assistant Professor in the Department of Preventive Medicine, School of Population Health at the University of Mississippi Medical Center. Dr. West’s research, published in Age & Ageing, focuses on identifying risk factors for cognitive decline and dementia that will identify high-risk populations and lead to strategies for prevention.

brainDecline in cognitive function in late adulthood has been associated with an interesting cluster of metabolic abnormalities, such as diabetes and obesity. This suggests the possibility that genetic factors that are related to metabolic disease may also be related to cognitive decline. The peroxisome proliferator-activated receptor gamma (PPARG) gene is known to play key roles in fat and glucose metabolism. In our study, we investigated a common mutation in the PPARG gene (Pro12Ala) to determine its relationship with cognitive decline. Continue reading