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

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

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

“The Emperor’s New Clothes”

Professor Martin Green OBE has had an extensive career in NGO development, both in the UK and internationally, and is Chief Executive of Care England, the largest representative body for independent social care services in the UK. He will be speaking at Living and Dying Well with Frailty event on 6 March. Follow the conference on the day via #bgsconf

We have now got a Department of Health and Social Care, what a difference that is going to make (I said sarcastically). With increasing regularity, the Government seems to think that messing about with the headed paper is a route to change. How much evidence do they need that changing titles and rejigging the logos is not going to deliver the transformational change that is required in order to deliver the route map to integrated services. If we had spent one tenth of the money we have spent on new titles, new structures and new logos on culture change, we would be in a far better position than we find ourselves today and the integrated services that citizens are crying out for might be a more attainable goal. Continue reading

Spring Speakers Series: Are rules of thumb the answer?

Nathan Davies is a Senior Research Fellow at University College London focusing on care for people with dementia towards the end of life and supporting family carers. In this post he talks about his upcoming talk at the BGS Spring Meeting in Nottingham on his work developing rules of thumb for providing care towards the end of life for someone with dementia.

Can rules of thumb help manage uncertainty and the challenges facing practitioners caring for someone with dementia at the end of life?

We know that caring for someone towards the end of life can be a rewarding and intimate experience with that individual and those close to them. However, unfortunately for practitioners it can also be emotionally tough and challenging. This is particularly the case when caring for someone with dementia towards the end of life. Continue reading

Practical palliative care after stroke

Dr Ruth England is a Consultant in Palliative Medicine at Royal Derby Hospital. She tweets @DrRuthEngland. She will be speaking at the upcoming BGS event Living and Dying Well with Frailty on 6 March in London. Please note this event has now SOLD OUT.

Palliative care is an active, holistic approach to those facing life-threatening illness. Good palliative care allows us ‘to live as well as possible for as long as possible’; and includes support for those approaching the end of their life.

In the UK, someone suffers a stroke every 5 minutes. Although there has been a decline in stroke mortality, it remains a leading cause of death in those aged over 65.  There a high risk of dying immediately after an event, and 40% of those affected by stroke die within a year. Long term survivors are likely to be burdened with ongoing physical, psychological and social issues. Continue reading

How was your BGS Autumn Meeting 2017?

David Scott is a 78 year old retiree from Teacher Education with type 2 diabetes and heart failure. In retirement he has developed a strong interest in patient engagement issues. These are engaged with via the Alzheimer’s Society, NiHR (specialist group on Ageing) Age UK and the Stem Cell Bank. He attended the BGS Autumn Meeting 2017 as a patient representative. Register for the BGS Spring Meeting, 11 – 13 April at NCC in Nottingham.

How was your BGS Autumn Meeting 2017? I enjoyed meeting a lot of people with plenty of experience and don’t the Geriatricians look young these days!  Remember that I am 78 years plus. What about that location? Very intimidating on first arrival but once in your allocated space, superb facilities. Plenty of toilets, plenty of overall space, good catering – with alternative if you didn’t mind going a bit further. Found the steps down between levels quite hard but recognise the need to do your daily exercise!  One or two smaller rooms got a bit crowded for some presentations but, in general, presentations well supported. Continue reading

Geriatric Oncology: Why older patients need a special approach

Anthea Cree is a clinical oncologist currently undertaking an MD in advanced radiotherapy at The Christie NHS Foundation Trust. She co-founded a group within the hospital to work towards better outcomes and experience for older patients.

I recently did a clinic during which the average age of the patients was over eighty and the oldest nearer to one hundred. This is probably not unusual for the readers of this blog but I’m an oncologist, not a geriatrician.

I’ve been an oncology registrar for six years and even over this short period of time, it seems like encountering octogenarians in clinic has changed from unusual to routine. This is a positive step as a third of cancer patients are over 75 years old and in the past many did not get a chance to see a specialist as they were automatically deemed to be too old for treatment. Continue reading

Is this your first time?

Dawne Garrett is Professional Lead for Older People and Dementia at the Royal College of Nursing (RCN) Eleanor Sherwen is Professional Lead for Palliative and End of Life Care, and also works at the RCN. They will be delivering a workshop at Living and Dying Well with Frailty Meeting on 6 March in London. Please note this meeting has now sold out and there will be no on site registration. To join the waiting list please email registrations@bgs.org.uk

Approaching end of life care discussions with the patient for the first time…

Dawne and I have been asked to deliver a 60 minute workshop on this key and sometimes challenging area of practice. The importance of choice and the delivery of holistic person centred care is repeatedly highlighted in the literature, both from researchers and policy makers.  Yet how can we even begin to deliver person centred care when there is at times a reluctance to open up and initiate these essential conversations? Let alone when communicating with someone who has limited sight, poor hearing and cognitive impairment. The evidence says that professionals can feel more comfortable approaching conversations in relation to sex, rather than having conversions with patients and those that are important to them focused on death and dying.  Continue reading

Spring Speakers Series: The meaning of life expectancy

John Gladman is Professor of the Medicine of Older People, Division of Rehabilitation and Ageing and Honorary Consultant in Health Care of Older People at Nottingham University Hospitals NHS Trust. He will be speaking at the upcoming BGS Spring Meeting in Nottingham.

Is getting old about decline or about personal growth?

At the BGS Spring Meeting in Nottingham, the organisers have, perhaps unwisely, asked me to give a lecture. I presume I was asked in view of the large and active research group in academic geriatrics in Nottingham, Derby and Leicester for which I have become the titular head (I think that’s what they call me). I intend to abuse this honour by ruminating on a few things that puzzle me as I approach my dotage and probably won’t mention our research at all. Continue reading