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

Inaugural BGS Eastern Region Geriatric SpR Research & Audit Presentation Day

Katie Honney obtained her MBBS BSc (Hons) at University College London. She completed her foundation and core training in the eastern deanery and is currently working at the Queen Elizabeth Hospital, King’s Lynn, as a specialty registrar in geriatric medicine.

cambridgeOn the 24th June 2016 the inaugural BGS Eastern Region Geriatric SpR Research & Audit Presentation Day took place at NAPP Pharmaceuticals, Cambridge Science Park. The wealth of excellent research and audit work conducted by trainees within the region prompted the need for an opportunity in which this work could be shared among colleagues.

The day commenced with an informative presentation from Prof John Potter relating to blood pressure control and cognitive function. Prof. Potter told the audience about the rising prevalence of hypertension with age, as well as discussing how cognitive impairment is associated with the extremes of blood pressure. Continue reading

Perioperative Assessment at the BGS Autumn Meeting

Dr Jugdeep Dhesi is Chair of the BGS Perioperative Care of Older People Ungergoing Surgery SIG (POPS) and is consultant physician and clinical lead for the POPS service at Guy’s and St Thomas’ Hospitals. She will be Chairing the POPS Session at the BGS Autumn Meeting.

perioperative-nursing-300x199Older surgical patients are presenting us geriatricians with challenges. How should geriatric medicine fit into the national agenda for perioperative medicine? Which models of care work best in improving outcomes for this complex multimorbid group of patients? Do different surgical subspecialties require different approaches? How should these services differ between the district general and teaching hospital? Should elective and emergency older surgical patients be given equivalent geriatric medicine input? How can we balance the frequent calls to involve geriatricians in the care of older surgical patients against the numerous unfilled consultant posts in ‘traditional’ geriatric medicine that already exist? These issues will be explored in the POPS SIG session at the BGS meeting in Glasgow (Friday 25th November). Continue reading

Take the high road or the low road…but don’t miss the BGS in Glasgow this November!

Dr Eileen Burns has been a geriatrician in Leeds since 1992 and is President-Elect 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

eileenburnsThe Autumn Meeting of the BGS in Glasgow this November looks to be a great event with a broad range of topics and sessions.

But the day that excites me the most is Wednesday November 23rd.

Many of us have been approached by commissioners of services to “move into the community” in some way (in whichever part of the UK we are based). Others have seen the need to look at alternatives to acute hospital care for older patients with less severe illnesses, and it’s been clinicians rather than commissioners or managers who have been the spark for new developments. Continue reading