Improving Continence Care for Older People

Vikky Morris is Chair of the BGS Bladder and bowels Special Interest Group. She will be speaking at the upcoming event Improving Continence Care in Older People on 21 September in Manchester.

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.

Reflections on ‘NOT Forgotten Lives: Felixstowe 2017’

Liz Charalambous is a nurse and PhD student. She tweets at @lizcharalambou and is a regular guest blogger for the BGS. Here she reviews ‘NOT Forgotten Lives: Felixstowe 2017’ edited by Julia Jones and Bertie Wheen

‘NOT Forgotten Lives’ is a written record, produced for the 2017 Felixstowe Book Festival, which celebrates the lives of older people living locally in residential accommodation. This slim volume is organised by an overview of what life story work is about, followed by photographs and accounts of the life stories of residents living in nursing and residential accommodation in Felixstowe. It concludes with a personal reflection from the co-editor, Bertie Wheen.

Why is this book important?

In a world where dementia is on the increase there are political, economic, ethical and often personal reasons why society must wake up to the reality of the disease. Currently an estimated 50 million people worldwide live with dementia, with a forecast of 131.5 million by 2050.  In the UK there are 850,000 people living with the disease, estimated to increase to 2 million by 2050. These figures alone suggest that dementia is a disease which can no longer be ignored.

Spring Speakers Series: Why mouth care matters?

Jessica Mann, Dental Core Trainee and Mili Doshi, Special Care Consultant. Mili Doshi will be speaking at BGS Spring Meeting in Gateshead. 

Did you know there are more bacteria living in your mouth than there are people in the world?  The mouth is biggest hole in the body – it is highly visible, we eat though it, talk through it and smile with it, but when we need help caring for it, often that help is not there! Yet deteriorating oral health can have severe consequences for the rest of the body…

If you have a problem with your vision a doctor will check your eyes, but if you are not eating is it common practice for a doctor or nurse to check if there are problems with the mouth? 

Wrinkly hands or ‘cocaine ‘fro’? You decide…

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 is currently a PhD student at The University of Nottingham. She tweets at @lizcharalambou and is a regular guest blogger for the BGS. Her blogs are her own opinion and do not represent the opinion of her employer or any other organisation.

I came across a USA you tube clip the other week which challenged my thinking on HCOP care. The footage was of a young man who has teamed up with his grandma to make, what I would describe as ‘stereotype-busting videos’ of his visits to see grandma in ‘the ‘hood’. I initially thought it was controversial and mildly exploitative (after all he talks to his grandma about her ‘cocaine ‘fro hairdo). I had to watch them a few times to decide that actually, this challenges my perceptions of how we engage with older people. Watching grandma rolling meatballs to ‘roll out’ rap music and shimmying her shoulders following a successful bottle flip challenge, I was hooked. The couple do Q & A sessions, mannequin challenges and twerking dance offs, cover naughty topics, and cause general mayhem and shenanigans at a pet store, among other (more saucy) clips, and seem to have a great deal of fun together in the process.

Do attitudes toward older patients even matter?

Rajvinder Samra is a Lecturer in Health and Social Care at The Open University. She is interested in healthcare professionals’ attitudes towards older patients. If you’re interested in this topic at all, get in touch with her at Rajvinder.samra@open.ac.uk

Does it matter if doctors like older patients? Is there any point in working out if doctors have positive or negative attitudes towards older patients? Surely it’s irrelevant because doctors are professionals that can separate their personal and professional feelings. Maybe they can, but that’s not the point as to why these questions are important.

The US has a long history of looking at medical students’ and doctors’ attitudes towards older patients and seeing if this is related to their likelihood of working in specialties like geriatrics. It seems like you are more likely to consider geriatrics if you have more positive attitudes towards older patients than people with more negative attitudes. Well, that seems obvious, doesn’t it?

The chasm of dementia; a carer’s perspective

Sue Newsome supported her Father during the last year of his life after he was diagnosed with Vascular Dementia. In this blog she shares her thoughts and feelings from a carer’s perspective.  

Supporting someone with Dementia is a contradiction of what it is ok to feel and the guilt about those feelings. A whole raft of thoughts, feelings and behaviours that I continually checked and reviewed. My relationship with Dad changed, he had never said he was scared before and I was to hear this from him throughout his Dementia journey.

Initially in his phone call to me telling me ‘Sue I am scared I am having a Stroke’ which although slurred was articulate, to the same feeling the night before he died when despite his end stage Dementia and aspiration pneumonia, when he struggled to breathe, he managed to say ‘I’m scared’. His fear and mine punctuated our relationship for the last year of his life. Our fear of the future what it held and how we could adapt. It felt like I held my breath for a year. Living on adrenaline, the skipped heartbeat when the phone rang, what had happened to Dad this time!

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.

I was proud to be invited to speak this week at the John’s Campaign Conference on 12^th 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.

‘Help yourself’; Supporting older people towards independence

Rudi GJ Westendorp, is Professor of Medicine at Old Age at the Department of Public Health and Centre for Healthy Ageing, University of Copenhagen. In this blog he discusses his recent Age and Ageing paper New horizons: Reablement – supporting older people towards independence.

The majority of older people wish to remain independent and live in their own homes for as long as possible. Instead maintaining a cruising altitude however, the process of ageing forces many to descend towards dependency and long-term care.

It’s never too late to learn new ways for coping by yourself and to make preparations for independent living in older age. But it is a shame that too often these good intentions are superseded by doubts and avoidance.

Adding meaningful to activities

Wendy Perry has been working with older adults for over 25 years, and has been specifically involved in the development, staff training and management of memory support services in both the US and the UK over the last 15 years. In the past she has worked for RSAS AgeCare as a Dementia Training Specialist and for the Association for Dementia Studies at the University of Worcester as a Dementia Practice Development Coach.  After moving to Scotland in 2013, she began work for Balhousie Care Group as the Dementia Services Development Lead. Of particular interest to her are the improvement of services for people with advanced dementia, understanding and responding to stress and distress in people living with dementia, and empowering care staff to make positive changes in their work culture. @dementiacentre

All of us at times do meaningless activities. We flip through channels on the TV or play silly games on our mobile phones.  Sometimes these activities serve as “breaks” from more intensive activity or time fillers when waiting for a person or an appointment. But rarely do we finish doing an activity like that and feel as though we have accomplished something, nor do we usually feel like we have contributed to the world in a positive way.  Not that we should be constantly out to change the world with our actions, but let’s face it, Candy Crush rarely made anyone feel better about themselves.

Help The Aged

Dr Sean Ninan is a registrar in Geriatric and General (Internal) Medicine in the Yorkshire Deanery. He tweets at @sean9n and @gerisreg . 

Here Sean writes on his blog, Senior Moments, about the importance of empathy in caring for older people.

Help The Aged.

I can see it everywhere.

In the patient list for the admissions unit – “acopia.”

In the nurse’s voice “Can you give her some lorazepam please?”

In the junior doctor’s tone “Another one admitted with falls. Nothing wrong with them.”

In the referral letter – “This lady has no (insert your own specialty here) -ological issues. Please could you take over her care”

Some healthcare workers do not enjoy dealing with older people. Part of me can understand why. It’s hard. Frail older patients place a lot of demands on staff. They need help washing and dressing. They need help with eating. They need help going to the toilet. They call out. They call out again. About the same thing you just reassured them about. And they don’t tell you what’s wrong with them. They come in “off legs” or confused, the same presentation hiding a multitude of diagnoses – from constipation to cord compression.