‘Proud Carer’

Karolina Gerlich is a proud carer and a NACAS Director. She has worked as a carer for the past 7 years, and brings experience of business management and providing training. She is studying for a degree is Psychology with the Open University and for a BTEC HND in Health and Social Care. Follow @NacasUK

The National Association of Care & Support Workers (NACAS) was founded in 2016. The association is directed by care workers and aims to improve health and social care through our members. We are working hard to improve training standards and ensure that care profession gets the respect and recognition it deserves.

There are a variety of titles given to those who provide care professionally; our members are home-carers, care-home carers, personal assistants, support workers, healthcare assistants, as well as managerial staff. Regardless of the job title, we all provide care to people, and often spend a great deal of time with them. Continue reading

Spring Speakers Series: Clinical Psychologists in Memory Services

Reinhard Guss is a Consultant Clinical Psychologist, Clinical Neuropsychologist; Dementia Workstream Lead, Member of the Faculty of the Psychology of Older People, BPS and Deputy Chair, Memory Services National Accreditation Programme. He will be speaking at the upcoming BGS Spring Meeting in Nottingham.

Clinical Psychologists have been part of Memory Clinics as long as they have been in existence as a part of service provision in the UK, using neuropsychology skills in the diagnostic process and in the development of coping strategies and employing clinical and psychotherapeutic skills in assisting with adjustment to a dementia diagnosis and in the support of families and carers.  An overview of the Psychology position on dementia can be found in the recent paper to the British Psychological Society’s Dementia Advisory Group.

Historically, the diagnosis of dementia was often the domain of Neurologists and Psychiatrist, particularly when this affected younger people, while Geriatricians would have encountered dementia in older people, and may or may not have seen a need to diagnose it in socio-historic context where dementia was seen as untreatable and often a part of ageing that was to be expected. Continue reading

New guidelines for recognising and assessing pain in older adults

New recommendations to help healthcare professionals recognise and assess levels of pain in older people were published today in the scientific journal Age and Ageing. The guidelines were developed by the British Geriatrics Society, the British Pain Society, the Royal College of Nursing, in collaboration with researchers at Teesside University, Anglia Ruskin University, University of Bournemouth, Centre for Ageing Better, and the Centre for Positive Ageing.

There is growing evidence to demonstrate that chronic pain is more prevalent among the older population and pain that interferes with everyday activities increases with age. Alleviating pain in the older population is therefore a priority but presents a number of challenges, especially in relation to communication with patients. These guidelines seek to address specific areas in which improvements can be made. To support this aim all existing publications on acute and chronic pain screening and assessment in adults over 60 years of age were identified, and two reviewers independently read and graded the papers according to the National Health and Medical Research Council criteria (1999b). Continue reading

How (I try!) to avoid a hospital admission for someone with frailty

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

The bag I take on every home visit has numerous pockets with endless equipment and forms required at my fingertips. I clip the same badges and emergency kit to myself at the start of every shift and I take this order and strict routine with me into environments over which I have little control.  It is within this mix of structure and chaos that the creativity to manage conditions and sometimes crises within a community setting arises.

Publications and conferences have explained the importance of avoiding unnecessary hospital admissions (especially for those with frailty) and commissioners require data on the number we have achieved. Continue reading

Spring Speakers Series: An overview of post stroke visual impairment

Claire Howard is a Stroke Specialist Research Orthoptist based at Salford Royal Hospital and is part of the VISION research unit at University of Liverpool. She holds an NIHR clinical fellowship and is currently researching the area of adaptation to post stroke visual field loss. Her main field of interest is rehabilitation of visual impairment following stroke. She will be speaking at the upcoming BGS Spring Meeting in Nottingham.

The size of the problem: the point prevalence of visual impairment in stroke survivors has been reported as 72% (Rowe, Hepworth, Hanna, & Howard, 2016). This visual impairment can be the result of a range of different problems either individually or in combination; these problems include visual field loss, eye movement disorders, reduced / blurred vision and visual perception defects.  In the post stroke period, a person may be experiencing a visual impairment that is of new onset, or their visual problems may pre-exist the stroke.  Continue reading

Swallowing Awareness Day #swallowaware2018

Esther Clift is a Consultant Practitioner in Frailty and Chair of Wessex BGS, as well as the Vice Chair of the BGS Nurses and AHP Council. She tweets as @EstherClift

The Royal College of Speech and Language (RCSLT) held a Symposium on dysphagia to work collaboratively at a system wide level in order to improve patient care, safety and outcomes for adults with dysphagia. The current prevalence data was presented in conjunction with NHS Improvement and the Academy of Medical Royal Colleges. Kamini Gadhok, MBE, the CEO for the RCSLT opened the symposium.

Dysphagia is a significant issue for patient safety. The reality of choking and asphyxia is firmly on the agenda since some high stake cases in February 2015, over ‘a risk of death from asphyxiation by accidental ingestion of fluid/food thickening powder.’ Continue reading

Creating a ‘Frail Friendly’ Acute Medical Unit… ‘not rocket science’

Teresa Dowsing trained as a physician associate at the University of Birmingham Medical School. She has worked in geriatric medicine for around 7 years and is the Frailty Lead for the George Eliot Hospital NHS Trust. To read more about physician associates and the British Geriatrics Society click here.

Creating a ‘Frail Friendly’ Acute Medical Unit (AMU) at George Eliot Hospital NHS Trust ….or what some specialities in my Trust used to call ‘not rocket science’…

Thinking about the latter part of this title, most of us that try to ‘practice’ geriatrics understand that it does sometimes feel like some form of mysterious dark art. A pinch of medicine, followed by a smidgeon of rehabilitation, mixed together with a drop of social care, a big dollop of communication and a dash of common sense. Simple? Not always….. Continue reading

Spring Speakers Series: Developing an Intervention for Falls in Dementia

Louise Allan is a Geriatrician with a specialist interest in the Neurology and Psychiatry of Old Age. Her research interests include the non-Alzheimer’s dementias and the physical health of people with dementia. She will be speaking at the upcoming BGS Spring Meeting in Nottingham.

Between 47-90% of people with dementia (PWD) fall at least once a year (almost ten times more often than controls). After a fall, PWD are less likely to recover well, more likely to be hospitalised, are hospitalised for longer and are more likely to require increased care. We currently know little about the care received by these patients. There is evidence to suggest that staff may perceive PWD as less capable of rehabilitation and staff in community services providing follow-up care may not have specific training in the care of PWD. Continue reading

Delirium awareness is not just for hashtags, it’s for life

Dr Shibley Rahman is an academic physician interested mainly in dementia and frailty. He tweets at @dr_shibley

My most recent experience of delirium was truly terrifying, to the point that, as a care partner of a close relative with dementia experiencing delirium, I felt I needed counselling about this admission to a London teaching hospital.

I have now witnessed delirium ‘around the clock’ for half a month so far.

Delirium research is not taken as seriously as it should be.

Where for example is the research which explains the neural substrates of hypoactive and hyperactive delirium? How long do ‘sleep episodes’ last for? Is it a good idea to wake someone up while he is sleeping? Are there are any neuroprotective agents which prevent long term deterioration after delirium? How much of the delirium will the person experiencing it actually remember? Continue reading

Palliative care provisions are not meeting the needs of an ageing population

A commentary published today in Age and Ageing, the scientific journal of the British Geriatrics Society, warns despite the fact that frail older people with multiple illnesses and end stage dementia are the most rapidly growing group in need of palliative care current provisions are not aligned to meet their needs.

The authors of the commentary noted that current projections indicate that between 25% and 47% more people may need palliative care by 2040 in England and Wales. A high proportion of these people will die following a prolonged period of increasing frailty and co-morbidity including cancer, but also other long-term conditions such as heart failure, chronic obstructive pulmonary disease, diabetes or renal failure. Continue reading