Dr Shane O’Hanlon is a consultant geriatrician with a special interest in surgical liaison and cancer care for older people. He tweets @drohanlon
As geriatricians seem ever thinly spread, the possibility of us providing input to the population of older people with cancer seems challenging – especially when you consider that a majority of cancer diagnoses and deaths occur in the over 65s. However oncogeriatrics has taken root in the past 2 or 3 years and there are now a few centres nationally offering just this approach. For those geriatricians who are hoping to provide it (or oncologists who are trying to entice them) this book will be of great interest.
“Problem solving in older cancer patients” is published in association with the Association of Cancer Physicians (ACP), and also the British Geriatrics Society (BGS) (but this of course does not affect the objectivity of this review!). It represents a great team effort by a range of geriatricians and oncologists, including trainees. Continue reading
Adhi (V Adhiyaman), geriatrician and Chair of Welsh council of the BGS. Tweets at @adhiyamanv
Every clinician hates having sleep outs. Sleep outs or outliers used to be a rare occurrence in the past and happened only in extremely busy winter months. Now it is a norm due to reduction in bed capacity across England and Wales. In every hospital there are around 15-30 sleep outs at any time (even more if one includes the patients in emergency department waiting for a medical bed).
Most of the sleep outs are direct admission of medical patients to non-medical wards. It is not the clinicians who decide the sleep outs anymore. Bed managers make this decision and frequently hassle the medical registrars to identify sleep outs so that they don’t have to take the ownership of their decisions. Registrars are fed up of doing this as they are always busy with the take or dealing with other medical issues. Continue reading
Jullie Tran Graham is a Programme Manager in the Health Lab at Nesta. She has an interest in our (you, me, and the rest of society) collective ability to work alongside public services to make positive contributions to the way services are provided. She tweets at @tran_graham
Volunteering is a long-established tradition across the NHS. Millions of people already volunteer in health and care, but tens of millions would consider it. How do we tap into this resource most effectively and ensure that volunteering input is creating the most impact on patient experience and outcomes? The Helping in Hospitals programme looked to answer these questions and more. In 2013, Nesta, the UK’s innovation charity, launched the Helping in Hospitals programme, with funding from the Cabinet Office and the Department of Health. Over the past two years, we have worked with ten hospital trusts in England to support the creation of impact volunteering opportunities such as roles that improve dementia care and roles that facilitate better nutrition for older patients. We have also worked with our evaluation partners, The Social Innovation Partnership (TSIP), to systematically measure of the impact of these volunteering roles in hospitals through informal match comparison groups, where possible and pre-post approaches. Continue reading
Anna Davies is Policy and Research Manager at Independent Age.
As a charity supporting older people, we know that conversations about ageing and future care needs are often put off until times of crisis. In some ways this should come as no surprise – thinking about mortality and threats to independence stir up complex emotions for everyone. But we also know the impact of these missed conversations: in particular families struggling to make decisions around care or housing without being sure of their relatives’ wishes. And with more and more older people likely to be relying on family support in the future – one estimate suggests a 63% increase in the number of older disabled people receiving informal care by 2035 – this is not an issue that is going away. Continue reading
Dr Corina Naughton, is a senior lecturer in the Florence Nightingale Faculty of Nursing and Midwifery, Kings College London. Corina is joint Lead for the Older Person’s Nurse Fellowship programme. She tweets at @corina_naughton
This was the first year of the Older Person’s Nurse Fellowship (OPNF) conference, hosted by the Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, in collaboration with Health Education England (HEE). The conference brought together leading older persons’ nurse research and front-line nurse-led quality improvement initiatives undertaken by senior clinical nurses from the OPNF programme. The conference was chaired By Baroness Sally Greengross and Sir Keith Person (Chair HEE). Continue reading
Kirsty Hendry is a research assistant based at Glasgow Royal Infirmary having recently completed her PhD at the University of Glasgow. In this blog she discusses her recent Age and Ageing paper looking at screening of delirium in older, acute care in-patients. Kirsty can be contacted at Kirsty.Hendry0@gmail.com
Delirium, suggested to be the most common psychiatric disorder suffered by older hospitalised individuals, has a low clinical awareness. This is despite existing guidelines such as those produced by the National Institute for Health and Care Excellence (NICE) and Healthcare Improvement Scotland (HIS) being in general agreement that delirium screening is important in older hospitalised patients. Continue reading
Liz Charalambous is a qualified nurse on a female, acute medical HCOP (Health Care for Older People) ward at Queen’s Medical Centre, Nottingham University Hospital Trust. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.
Beloved old age is a fitting tribute to Margery Allingham, author of detective fiction (including most notably that of Albert Campion, later converted to a TV series). Published on the 50th anniversary of Allingham’s death, and illustrated with black and white photographs from both eras, the book is a work of two parts. It contains the accounts of caring for older relatives, seamlessly interposed between each era to span over half a century. Allingham’s previously unpublished work, ‘The Relay’, describes her experiences of caring for three elderly relatives more than fifty years ago. The account is brought to life by Julia Jones as she picks up the baton and continues the story with her experiences of being a carer for her mother with dementia, to present the story of ‘Beloved old age and what to do about it’. Continue reading
Caroline Cooke is BGS’s new Policy Manager. She joined us at the beginning of June. Here she explains the significance of STPs for health and care services in England.
The constant change and the number of new initiatives in the NHS can be bewildering if you haven’t been directly involved at the start. Or if you have been involved you may be experiencing a mixture of excitement, frustration or cautious optimism at the prospect of new ways of working that are ultimately aimed at delivering fully integrated health and care services. Staying up to date and engaged with the plans that NHS England is driving forward is key if you want to have an influence on them. Continue reading
Pamela Levack is Medical Director of the charity PATCH – Palliation And The Caring Hospital firstname.lastname@example.org
David Oliver’s recent blog in the BMJ End of Life Care in hospital is everyone’s business, reports on the findings of the recent Royal College of Physicians Audit into End of Life Care. The two main findings, a need to increase the number of specialist palliative care doctors and specialist palliative care nurses in hospital and to ensure that newly qualified doctors have more knowledge and confidence dealing with end of life situations, match the aims of our recently established charity PATCH Palliation And The Caring Hospital Continue reading
Dr Martin Wehling is Professor of Clinical Pharmacology at the University of Heidelberg. He is a board certified internist with expertise in cell physiology, steroid pharmacology, nongenomic steroid actions, clinical trials and clinical medicine. He discusses his Age & Ageing Paper VALFORTA: a randomised trial to validate the FORTA (Fit fOR The Aged) classification.
Drug therapy is the most relevant therapeutic intervention in medicine; older people tend to suffer from multiple diseases (multimorbidity) and thus are likely to receive multiple drug treatments (polypharmacy). It has been demonstrated that patients aged 65 and older take five or more drugs in 44% (male) and 57% (female) of cases and 10 or more drugs in 12% of cases.
Taking 10 and more drugs is unpredictable and expensive and seems to cause more harm than good, given that up to 100,000 deaths in the United States annually are attributed to medications. Guidelines are considered as main drivers of therapeutic decisions under the conditions of evidence-based medicine (EBM). Continue reading