Autumn Speakers Series: What is geriatric rehabilitation? Towards a unifying concept

Romke van Balen is an Elderly Care Physician in Rotterdam and Senior Researcher in Leiden. His main field of interest is geriatric rehabilitation. He will be speaking at the upcoming BGS Autumn Meeting in London.

Although geriatric rehabilitation in most countries is considered to belong to the core tasks of geriatricians, there is no consensus about definition and target groups of patients.

Decades ago, the Boston Working Group defined geriatric rehabilitation as a multidisciplinary set of evaluative, diagnostic and therapeutic interventions whose purpose it is to restore functional ability or enhance residual functional capacity in elderly people with disabling impairments. When looking at this definition, one wonders if it separates geriatric rehabilitation from the general aim of geriatric medicine. Only palliative care clearly has another aim. Continue reading

Seen the doctor on the Tele? Patient centred care needs to arrive for all, and none more urgent than for our older patients

Chris Subbe is a Consultant in Acute, Respiratory & Critical Care Medicine. He is a Service Improvement Fellow with the Health Foundation. He does research on patient safety at Bangor University. He tweets @csubbe

Unsurprisingly many of us have more medical needs as we get older. While some people manage to stay remarkably fit, for others it is getting more difficult to get around town or worse across country. The hike around an overflowing car park of an inner-city hospital does surprisingly little for mobility, and most people get little value from sitting in an outpatient waiting area to wait while their medical team is struggling with the application of queuing theory to healthcare.

A few years ago, when granddad was sent a follow-up appointment for his cardiac surgery several months after the operation, I was suspicious. I rang the secretary of the colleague who had done an amazing job on his heart to ask for the reason for the review. “An important part of quality assurance: we like to make sure that everything has gone well”. I explained that granddad had been in hospital, survived prolonged rehabilitation, and had already been followed up by an excellent local geriatrician and one of our brilliant cardiologists. He felt well. I suggested cancelling the appointment. Continue reading

Can Geriatric Medicine be learnt through reading ‘George’s Marvellous Medicine’?

Dr Amy Heskett is a Speciality Doctor working in a Community Geriatrics team within West Kent called the Home Treatment Service. This team works alongside paramedics, GPs and district nurses to prevent unnecessary hospital admissions for people with frailty, multiple comorbidities, caring responsibilities or as part of end of life care.  The home visits use bedside testing and a multi-disciplinary approach to provide management of many acute medical presentations in a home-setting.  The development of these holistic plans requires a creative approach and the experiences often generate tweets @mrsapea and blogs at communitydoctoramy.wordpress.com

I read Roald Dahl’s ‘George’s Marvelous Medicine’ to my children today and my son said, “You really love the Grandma in this don’t you Mum?”

It’s true!  It was one of my favourite books during my own childhood and I now spend a large amount of time perfecting the Grandma’s voice for my children and absorbing the story with them as they snuggle on the sofa.  There is personal meaning to some of the pictures too and so a picture of George stirring the giant saucepan is hung on our kitchen wall.  The text describes ‘A rich blue smoke, the colour of peacocks’, at which point we cheer because Peacock is our family name. Continue reading

PSP – more than just difficult PD, and how geriatricians have a key role to play…

Carol Amirghiasvand is the Helpline and Information Services Manager for the PSP Association (PSPA). She has worked in the voluntary sector for nearly 20 years providing information and support to people with neurological conditions. Her current role is managing the Information and Support services provided by PSPA to ensure knowledge and understanding of PSP and CBD is increased and that people affected by these conditions have access to a more acceptable quality of care and support. Follow the PSP Association @PSPASSOCIATION

Progressive Supranuclear Palsy (PSP) is a commonly misdiagnosed neurological condition with an average age of onset of 63. Almost 40% of respondents to a recent survey by the PSP Association saw a geriatrician before being referred to a neurologist, meaning that geriatricians can play a vital role in identifying the disease and ensuring rapid access to the most appropriate care. Continue reading

Autumn Speakers Series: Is it just me… or have we listened and changed?

Sharon Blackburn has worked in the independent care sector for over 28 years, having previously spent 10 years in the NHS in a variety of roles. Sharon is currently Policy and Communications Director for the National Care Forum. She was awarded an CBE in the 2016 New Year’s Honours for services to nursing and the not-for-profit care sector. She tweets at @NCFSharon She will be speaking at the upcoming BGS Autumn Meeting in London.

Care Homes routinely feature in the press and not always for the right reasons. Sadly the negative experiences and stories do little to help us all promote the amazing work that is being done with people who live in care homes up and down the country. Instead it feeds peoples’ already distorted views and understanding, including those of professionals. Andrea Sutcliffe, Chief Inspector for adult social care at the Care Quality Commission (CQC) talks about the ‘mum’ test – “would this service be good enough for my mum?” I would suggest the ‘mum’ test needs to be more up close and personal… “would this service be acceptable to me”? Continue reading

Systematic reviews for studies of older people

Susan Shenkin is Associate Editor for Systematic Reviews at Age and Ageing journal. She has recently published Systematic reviews: guidance relevant for studies of older people. She tweets at @SusanShenkin

Systematic reviews and meta-analyses are increasingly common. Our recent article in Age and Ageing journal aims to provide guidance for people conducting systematic reviews relevant to the healthcare of older people. It’s essential that systematic reviews are performed by a team which includes the required technical and clinical expertise: if you’re planning to do a review, ask for advice and support early. We hope that highlighting these issues will also help people reading systematic reviews to determine whether the results will influence their clinical practice. Here is a summary of ‘good practice points’. Continue reading

Autumn Speakers Series: A glimpse into the future of acute care for older people; innovation, connectivity, transformation

Professor Roger Wong is Executive Associate Dean, Education in the Faculty of Medicine, University of British Columbia (UBC). He is a consultant geriatrician at Vancouver General Hospital, where he founded the Acute Care for Elders (ACE) unit that is replicated across Canada and internationally. He tweets at @RogerWong10 and is a key opinion leader in geriatrics and ageing. In this blog article he discusses the determinants that can transform the future of acute care for older people. He will be speaking at the upcoming BGS Autumn Meeting in London.

For all of us who work with seniors in the hospital setting, we often wonder what the future holds for acute care for older people. While our crystal ball may appear blurry on some of the exact details, we can certainly take a sneak preview now on three determinants that can change and shape the future of acute care geriatrics.

First, disruptive innovation in the medical sciences has already begun to transform the delivery of healthcare in seniors. Take cancer for example, which affects a significant number of older people every year. Continue reading

What does good look like when thinking about care homes?

Claire Goodman is Professor of Health Care Research at University of Hertfordshire. Claire has a district nursing background and is a NIHR Senior Investigator. Her research focuses on the health and social care needs of the oldest old, including those affected by dementia and living in long term care. She leads the DEMCOM study, an evaluation of Dementia Friendly Communities – @DEMCOMstudy @HDEMCOP

We have new neighbours. They moved three miles to improve their children’s chances of going to their preferred secondary school. If they had stayed put they would have been assured of getting a good state education. We are surrounded by Ofsted rated ‘good’ and ‘outstanding’ schools. The issue was that whilst it probably did not matter if their daughter went to a girls only or co-educational school, for their son, a boys only school, with a big focus on sport, would have been a problem. People in my local area know a lot about the schools, they know what the head is like, who the good teachers are, what extra-curricular activities are available and if it’s struggling with its budget. Continue reading

July 2017 issue of Age and Ageing journal is out now

The July 2017 issue of Age and Ageing, the journal of the British Geriatrics Society is out now.  A full table of contents is available here, with editorials, research papers, reviews, short reports, case reports book reviews and more.AA_46-03

Hot topics in this issue include:

  • Care home leadership
  • Physical restraint
  • Diet and muscle function
  • Prescribing for frail older
    adults
  • Treatment of overactive
    bladder

    The Editor’s View article gives an overview of the issue with a summary of highlights. This article is free to read and can be viewed here. Continue reading

    “Please remember I’m still a person!” A carer’s solution to help hospital staff provide person-centred and holistic care

    Zoe Harris cared for her husband at home before his dementia reached a stage where she was unable to cope, and he spent his final months in a care home. As a result of that experience, Zoe developed a range of communication tools to ensure that carers were aware of his needs and preferences, and which have subsequently been adopted by over 1,000 care homes and home care agencies. Her latest project is Mycarematters, an online platform where people, or someone on their behalf, can upload information to help hospital staff treat the whole person and not just their medical condition. @ZoeHarrisCCUK @Mycarematters @Care_Charts_UK

    When I look back, I think Geoff had been showing signs of dementia for at least eight years before his diagnosis, and it was only a matter of months after he was finally told that he had what was probably a mix of Alzheimer’s Disease and Lewy Bodies, that his condition took a turn for the worse. I had to admit defeat and he moved first to a dementia assessment ward and, three months later, to a care home for what turned out to be the final 13 months of his life. Continue reading