Dan Thomas is an ST6 working in Liverpool. He is the BGS Clinical Quality Group Trainee Rep and the Deputy Media Editor. He tweets @dan26wales
‘10 days in a hospital bed leads to 10 years’ worth of lost muscle mass in people over age 80’
I have lost count of the number of times I have quoted this fact, I use it when teaching on frailty, and I have used it when assessing people in the emergency department to explain the risks of hospital induced deconditioning. I regularly hear other Geriatricians use this fact. It is emblazoned across much of the #EndPJParalysis material, and is quoted (unreferenced) on the NHS improvement website. Continue reading →
1 in 3 women and 1 in 7 men over the age of 65 experience urinary incontinence. It is a significant problem associated with falls, fractures, social isolation, depression, urinary tract infections and moisture lesions. Faecal incontinence affects up to 10% of the population, although its prevalence is much higher in older people, nursing home residents (up to 60%), patients with cognitive impairment and neurological conditions. Numbers are also likely to be an underestimate due to the stigma attached to incontinence. Both urinary and faecal incontinence are associated with great expense, both personal and to the NHS (more than 2% of the NHS budget). In addition, in older people, incontinence is second only to dementia as a reason for admission to a residential or nursing home. Continue reading →
Dr Jenni Burton (@JenniKBurton) from the University of Edinburgh and Dr Patrick Wachholz (@Patrick23711608) from Sao Paulo State University joined 12 researchers from across the UK and 17 from across Brazil to participate in a Newton Fund researcher links workshop: ‘Identifying and addressing shared challenges in conducting health and social care research for older people’, held between the 11th-15th of June in Botucatu, Brazil. The workshop was funded by the British Council and the Sao Paulo State Research Foundation (FAPESP) and organised by the University of Nottingham and UNESP.
Over the course of five days we worked together under the supervision of our Brazilian and UK mentors (Prof Alessandro Ferrari Jacinto, Prof Paulo Villas Boas, Prof Vanessa Citero, Dr Adam Gordon, Prof Tom Dening & Dr Jay Banerjee) to share ideas, learn from each other and work on developing new collaborative research projects.
To set the scene, Brazil is the largest country in South America with an estimated population of 16 million adults aged 65 and over. Sao Paulo State has a population of 41 million people and is the most economically and research active state in Brazil with 34% of the GDP. Amazing stat of the week was that for every four research papers published in Latin America, two will be authored in Sao Paulo State! Continue reading →
The July 2018 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.
Hot topics in this issue include:
Blood pressure targets in treatment of hypertension
Probiotics and prevention of infection
Improving healthcare outcomes in care homes
Caregiver relationships and Parkinson’s disease
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 →
Dr Gaggandeep Singh Alg is currently a Consultant (AUC) Physician and Geriatrician working at the Royal Berkshire Hospital, UK. He is active in charity work supporting the most vulnerable in society and has an interest in equality and diversity. Twitter Handle @DrGSAlg
How often do we hear about the rapidly growing population of older people? Yes, we hear about it almost every day. But who are these older patients? Where are they originally from? What is their cultural and religious background? No one seems to be talking about that!
In the last 8 years while doing charity work in my free time I have noticed a growth in the older population from black, Asian and minority ethnic (BAME) groups. Older people from BAME backgrounds suffer from the same illnesses our other patients suffer from. However, in my experience they do not always know when and how to seek help. They have cultural, religious and language barriers which may prevent them from accessing health care services. Through the charity work I have seen many over 65 year olds living with signs and symptoms of various diseases, who have not been able to access the services we have built and provide! Continue reading →
Advance care planning (ACP) is a vital part of personalised care planning. This recently published document acts as a resource to support clinicians and practitioners who provide health and social care for people with dementia. It aims to ensure people living with dementia can develop an ACP through initiating conversations with their supporting clinicians and/or loved ones. It aims to offer a consistent standard of support for patients diagnosed with dementia using ACPs that are developed in partnership with patients and families. Continue reading →
Stephanie Robinson is an occupational therapist at Harrogate hospital working as the frailty team leader across the medical elderly wards and previously seconded into the Supported Discharge Service. She has had a key role in cross boundary working, outreaching from frail elderly inpatient based wards to the community.
The right intervention, at the right time, in the right place… How Harrogate District Foundation Trust therapists from the community and in-patient wards are tackling the national bed crisis: piloting a Supported Discharge Service.
The scientific journal of the British Geriatrics Society, Age and Ageing, and the Journal of the American Geriatrics Society have launched a joint initiative, publishing two articles debating the relative benefits and risks of treating hypertension in older people.
It is widely recognised that raised blood pressure is probably the single most important treatable risk factor for cardiovascular disease in later life. The evidence that older people can benefit from antihypertensive drugs has accumulated with a succession of randomised controlled trials over the past 35 years. These trials have shown reduced risk of stroke and myocardial infarction, as well as decreased total mortality. However, despite the extensive evidence that is now available, questions remain about who to treat and on optimal blood pressure targets. Consequently practice varies widely and many clinicians are uncertain about what best to recommend for their older patients. Continue reading →
Professor Sarah Hilmer works as a geriatrician and clinical pharmacologist at Royal North Shore Hospital in Sydney, and conjoint professor of geriatric pharmacology at Sydney University, Australia. Dr Danijela Gnjidic is a pharmacologist who is a NHMRC Dementia Leadership Fellow and Senior Lecturer in Pharmacy Practice at Sydney University, Australia.
One of the most reversible causes of a geriatric syndrome in our older patients is an adverse drug event. Approximately 1 in 5 hospital admissions amongst older people are due to adverse drug reactions and during their time in hospital 1 in 6 older people experience an adverse drug reaction. Consequently, comprehensive medication review is an integral part of the practice of geriatric medicine.
The process of a health professional withdrawing medicines for which the current risk may outweigh the benefit in their patient has been given a variety of names including the ‘geriatrician’s salute’ and increasingly ‘deprescribing’. Continue reading →