Jenni Burton is a Clinical Research Fellow in Geriatric Medicine funded by the Alzheimer Scotland Dementia Research Centre and the Centre for Cognitive Ageing and Cognitive Epidemiology at the University of Edinburgh. Here she discusses the results of two linked systematic reviews of predictors of care home admission from hospital. She tweets @JenniKBurton.
Care home admission from hospital has long been recognised as an area of significant variation in practice (Oliver D et al. 2014. Making our health and care systems fit for an ageing population) and one which remains a strategic target to reduce across the UK. However, more than half of care home admissions each year in Scotland come directly from hospital settings. It is therefore important to explore the predictors of this life-changing transition to help inform prognostication, communication with individuals and their families, service planning and the extent to which we can intervene to prevent or modify this outcome. Continue reading →
Louise Bate is an Engagement and Communications Officer with Healthwatch Dorset. Healthwatch is an independent watchdog, working to help people get the best out of their local health and social care services. Healthwatch enables local people to influence the delivery and design of local services, by sharing their views with health and care commissioners and providers: www.healthwatchdorset.co.uk
More than 51,000 carers in England are men aged over 85; a number that has more than doubled in the last decade. It’s such a huge number of people that it’s hard to imagine. We wanted to make the numbers real – so we’ve been working with Bournemouth University and the Carers Support Service to listen to older male carers, gather their stories and give them a stronger voice.
Carers over the age of 85 are the only demographic of carers where men outnumber women (59%). Men are more likely to become carers in older age than at other times in their life and usually as a result of caring for their partners. Continue reading →
Dr Reena Devi is a research fellow in the Division of Medical Sciences and Graduate Entry Medicine at the University of Nottingham. She is working on the PEACH (‘ProactivE heAlthcare for older people living in Care Homes) study, which is led by Dr Adam Gordon, and funded by the Dunhill Medical Trust. She will be speaking at the upcoming BGS Autumn Meeting in London. She tweets @_DrReenaDevi
Improving healthcare services delivered to older people is high on the national agenda. Nationwide initiatives are currently focusing on this, for example, six of the Vanguard projects set up in response to the 5 year forward view are specifically devoted to delivering new models of healthcare into care homes. Smaller scale initiatives are also being carried out in local settings, such as the PEACH project.
The PEACH project is using improvement science to bridge the gap between what we know and what we do in terms of the healthcare services delivered to care homes in South Nottinghamshire. The project is working with 4 clinical commissioning groups and their associated healthcare and care home providers, and is focusing on bringing healthcare services closer in-line with the Comprehensive Geriatric Assessment (CGA) model of care. Continue reading →
Dr Eileen Burns has been a geriatrician in Leeds since 1992 and is President of the BGS. She is currently Clinical Lead for integration in Leeds. She tweets @EileenBurns13 This blog originally appeared as part of Independent Age’s Doing Care Differently series. You can join the debate here.
We warmly welcome Independent Age’s new project, Doing care differently. Our members are passionate advocates for person-centred care. The role of geriatricians and specialist health care professionals starts with identifying the care and treatment that best suits an older person’s individual needs and wishes, and those of their families and carers. Delays in access to social care, and also in intermediate care, for example, occupational and physio therapy, create unnecessary barriers to person centred care, leading to poorer health outcomes, an increased likelihood of presenting at A&E, and people having to stay on acute hospital wards for longer than necessary. For older people with frailty the negative impact when this occurs is significant, and their health deteriorates with every additional day spent on an acute hospital ward. Continue reading →
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 →
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 →
Duncan Forsyth has been a consultant in geriatric medicine, at Addenbrooke’s Hospital, for 27 years. A believer in global warming, he noticed that staffing levels in hospital were often inadequate to ensure adequate hydration of his patients during any heat-wave and that admissions due to acute kidney injury were especially prevalent in care home residents and frail older people receiving substantial packages of home care. He advocates incorporating the weather forecast in to the risk stratification for hospitalised patients, care home residents and those receiving three or more home care calls per day; in order to promote a review of potentially nephrotoxic medication
As you look forward to enjoying the (hopefully) warm summer weather, spare a thought for those less fortunate than yourself, who are frail; less able to increase their fluid intake; who are dependent upon others for provision of drinks; and at risk of acute kidney injury due to the potentially nephrotoxic drugs that they are prescribed. A leader article in the BMJ 2009 (Olde Rikkert, et. al) highlighted the dangers of heat waves and dehydration in frail older people and the resultant excess mortality in this population. Continue reading →
Cassandra Leese is a Nurse, Clinical Supervisor and a wannabe dog owner. She occasionally remembers to tweet @contrarylass
In today’s economic climate, when health and social care are really feeling the crunch, I often find myself feeling morose about the future. Day after day we see the terrible pressures our overstretched services are under, read about the heartbreaking death of another promising doctor burnt out from battling it out in secondary care; or hear about another valuable service making drastic cuts. And selfishly, I’m rather cross that all this seems to have come at a time when I’m incredibly excited to have finally found my place in the nursing landscape, that of gerontology and geriatrics. Coming along to my first BGS West Midlands meeting this spring was a welcome reprieve from the madness spewed daily by the tabloids and renewed my faith that the good guys are still out there! Continue reading →
Alex Greenwood is a recent graduate who’s been exposed to the realities of domiciliary care through her work with Konnektis, a hub digitizing social care and communication, facilitating better care for those in their own homes. She tweets @konnektis
Having lost my grandparents at an early age, I had very limited understanding of the realities of care. Through my work with Konnektis, and the inherently person-centred process of co-design, I am gaining privileged access to the outstanding work of carers. A commonly misunderstood and under-appreciated profession, carers have been absorbing the the pressures of our overstretched care system for years and the sector is now at breaking point. Whilst recent public concern over sustainability of care in the context of an aging population is an important debate, it is these inspiring carers – all too often overlooked – whose stories I wish to share in this space. Continue reading →
David Paynton is a GP in an inner city surgery. He is also the Clinical Lead for Commissioning for the RCGP.
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.