New Collaboration Looks for Trans-Atlantic Common Ground in Geriatrics

Top research journals launch international editorial series tackling the latest in geriatrics clinical practice & public policy. Up first: commonalities “across the pond” for older adults with multimorbidity.

Healthcare professionals across the Atlantic and around the world need to think beyond single-disease guidelines as they look to provide high-quality, person-centered care for more and more older adults living with multiple chronic conditions, so say editors from the Journal of the American Geriatrics Society and the British Geriatrics Society’s (BGS’s) Age and Ageing in the first from a series of joint editorials launched today. The series will look for common ground in geriatrics “across the pond,” beginning here with the U.K.’s National Institute for Health and Care Excellence (NICE) guideline on multimorbidity, the medical term for those living with several chronic health concerns. Continue reading

Sarcopenia; a key driver of physical frailty

Miles Witham is a Clinical Reader in Ageing and Health, University of Dundee, and is Deputy Editor for Age and Ageing.

The BGS Autumn Meeting 2016 saw the launch of the newest BGS Special Interest Group – the Frailty and Sarcopenia Research SIG. The inaugural session, held in the main auditorium in Glasgow’s SECC was attended by several hundred delegates, and so far, over 100 members have signed up on-line to be part of the new SIG. So why do we need this SIG, and what do we hope it will achieve? Continue reading

Better Transfers of Care for Older People – how to improve transitions of care

Dr Olivier Gaillemin trained in Geriatric Medicine and now works as a consultant physician in Acute Medicine at Salford Royal Foundation Trust. He has developed a Frailty Unit embedded within the Acute Medical Unit. He sat on the NICE guideline development group for NG27 – Transitions of care for adults with Health and Social Care needs – as well as on the committee for the associated NICE Quality Standard QS 136. He attended the King’s Fund conference as a speaker.

On the day of the launch of their report on STPs, the King’s Fund hosted an event on how to improve transitions of care for older people admitted and being discharged from hospital. In these times of very real stress to the systems in which we work, when too often we seem to fail those vulnerable people we are all invested and motivated in supporting, it is easy to become despondent. Continue reading

Utilitarian versus Kantian ethics

Shuli Levy is a locum consultant geriatrician at the Hammersmith hospital, London, running liaison geriatrics and MDT support teams for tertiary specialist services. She has recently taken over as head of the BGS Ethics and Law special interest group. 

kant_461965I recently gave a talk to doctors and medical students in my department, about the difference in Utilitarian versus Kantian ethics and the implications for our practice as generalists and as geriatricians. It surprised me that no one, apart from one medical student, had heard the terms before. Not for the first time, I reflected on how so much of our daily work as geriatricians involves complex ethical and legal decisions but so little time is devoted to exploring and understanding them. We may use our precious CPD time to learn more about endocrinology in older people or novel approaches to the mitral valve, but rarely encounter patients for whom this is relevant in clinical practice. In contrast, ethical questions, and the statutory duties they engender, arise on every medicine for the elderly ward round, on most acute takes, daily in the community and in every MDM. Continue reading

Nutrition in geriatric medicine in context

Prof Finbarr Martin is a Consultant Geriatrician at Guy’s and St Thomas’ NHS Foundation Trust and Professor of Medical Gerontology at King’s College London. He is a former President of the British Geriatrics Society.

tnt-geriatric-marketing-brochure-a4-v14-page-001Do you reach for protein to nibble within minutes of finishing a session at the Gym?  Many do. Protein bars, pots of creatine and drugs you can get at the Gym are all very well but they’re wasted on fit young things. What we really need to do is keep the best stuff for older people, especially our patients. So, OK, we have to justify the cost – there needs to be some evidence. On the plus side however our patients are not pulled aside by WADA or the other anti-doping bodies so they could get away with anabolics or even the odd transfusion. On the minus side maybe the anabolics don’t work! But good nutrition does!

Continue reading

Global Summit on Aging and Health- personal reflections on a conference and a cultural exchange

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 and Chairman of the BGS Community Geriatrics Special Interest Group. She tweets @EileenBurns13

chinaI was fortunate enough to attend and speak at a Global Summit on Aging held in Shanghai recently. It was a fascinating event, with speakers from an enormous variety of backgrounds- from the US Embassy in Beijing, the World Health Organisation, and the United Nations Population Fund, as well as numerous Chinese Government office holders.

The summit was jointly organised by Columbia University, USA (under the auspices of the wonderful Professor Linda Fried) and Fudan University in China. Continue reading

BGS raising the profile of Sarcopenia and Frailty in older people

1025_atrophySarcopenia, the loss of skeletal muscle mass and function that accompanies ageing, has emerged as a key topic in geriatric medicine and represents a rapidly expanding field of research. Prevalence may be as high as 1 in 3 for frail older people living in care homes. There is increasing appreciation of sarcopenia’s importance for an ageing population and a growing understanding of its causes. The condition is closely linked to physical frailty and detection of sarcopenia is beginning to be incorporated into clinical practice, and to undergo large clinical trials.

To better represent this area the British Geriatrics Society has announced the formation of a new Special Interest Group (SIG) focusing on sarcopenia and frailty research.

In addition, to help raise the profile and aid the recognition of sarcopenia, a dedicated session covering diagnosis and treatment of the disease is being held at the BGS Autumn Meeting in Glasgow. Continue reading

Sometimes good things really do come for free!

Mary Ni Lochlainn is an Academic Clinical Fellow in Geriatric Medicine. BGS Junior Members’ Representative and on the BGS Trainee’s Council. She works at Queen Elizabeth Hospital, Woolwich @younggeris. Her email is marynilochlainn@gmail.com

picture-for-bgs-website-mary-ni-lochlainnMembership of the British Geriatrics Society (BGS) is open to all medical students and Foundation Year doctors and is completely FREE!

I joined the BGS as a first year medical student and thus have benefited from free membership for quite a few years now, and would highly recommend it to all those who are interested in the healthcare of older adults.

You do not have to have your mind set on specialising in geriatric medicine; as we all know the proportion of people older than 65 is growing faster than any other age group (WHO, 2002). In the United Kingdom the population aged 65 years and older is set to increase by two-thirds to reach 15.8 million in 2031 (Wise, 2010). Geriatric medicine is set to become the largest and most exciting specialty in medicine! Beyond that, healthcare professionals in all other specialties (medical, surgical and the rest) will be dealing with more and more older adults in their services. Continue reading

What has CGA ever done for us?

Graham Ellis discusses the NIHR funded research project looking into the effectiveness of Comprehensive Geriatric Assessments. As part of the project an extensive Delphi exercise is being undertaken which will include staff, patients carers and researchers.  As part of the Delphi exercise a CGA consensus meeting will be held at the BGS Autumn Meeting in Glasgow on the 24th November at 9:30-13:30.

seccWe are used to the idea that CGA is effective.  That still leaves us with a few problems.  Who does CGA help?  How does CGA help?  What are the crucial elements that make it effective?  Are wards better than teams and how can we be sure?

The challenge with black box interventions (complex interventions of multiple parts) is properly understanding the component parts and how they relate to each other.  If you don’t know how something works it can be hard to replicate it or even to improve on it.   Continue reading

John’s Campaign Conference; Stay with me

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 was one of the speakers at the John’s Campaign Conference. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.

johns-campaignI was proud to be invited to speak this week at the John’s Campaign Conference on 12th October. The conference proved to be an oasis of light, love, and hope in the often gruelling and lonely journey of dementia. Nicci Gerrard and Julia Jones, co-founders of John’s Campaign, who both have personal experience of caring for loved ones with dementia, pulled together a groundbreaking and heartwarming conference, which was nothing short of miraculous. Nicci and Julia began what they described as a ‘kitchen table revolution’ to campaign to change the draconian restricted visiting arrangements of adult hospital care, advocating that people with dementia should have the support of their loved ones while in hospital. Continue reading