Rebecca Winter is an Elderly Medicine registrar; she is currently taking a year out of programme as a Clinical Education Fellow at Brighton and Sussex Medical School (BSMS). Twitter: @rebeccawinter27
Muna Al-Jawad is an Elderly medicine consultant at the Royal Sussex County Hospital, Brighton. She works on a mixed acute medical and mental health ward.
It’s a familiar scenario, you are on your Elderly Medicine placement and you are asked: “Can you get collateral history about Mrs Smith´s cognition?” You don´t want to miss anything, but what exactly do they want to know?
Dementia is an increasingly common and important condition. In the UK, at least one quarter of acute hospital beds are occupied by patient with dementia, with admissions spread across a broad range of specialties. (1) Despite this, the UK National Dementia Strategy (2) has highlighted deficiencies in behaviour and skills of healthcare professionals caring for people with dementia. Continue reading
Liz Charalambous is a nurse and PhD student. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.
I am in the second year of a PhD researching volunteers in dementia and acute hospitals. The project came about as part of my clinical work as a staff nurse in older person acute care. It was while working on a prevention of delirium research study, I realised that volunteers could play an important role.
The first year of my PhD has been spent mainly completing modules and designing the project from scratch. I have lost track of how many drafts of countless documents have been sent to my long suffering supervisors as they guide me towards refining my ideas, sifting through my thousands of words to put together a robust study which will stand up to scrutiny. Continue reading
Dr Miriam Stanyon is a Research Fellow on the Achieving Quality and Effectiveness for Dementia Using Crisis Teams (AQUEDUCT) research programme at the University of Nottingham. She also worked, until very recently, for a number of years as a care assistant in care homes. Here she talks about work to establish agreed competencies for Registered Nurses working in care homes.
It is no secret that care home nurses get a bad press. If you type ‘care home’ into the BBC news website, the result is a series of stories about neglect and elder abuse, care homes put in special measures by the CQC or having to close due to lack of funding. Among nurses themselves, care home nursing has a lower status than working in the NHS. It has traditionally been seen as a job to do when you’re close to retirement or can’t get a job in a hospital. I remember speaking to a colleague after she had attended some CPD training (which she had to self-fund and attend in her own time) and she expressed how she felt embarrassed to ‘only work in a care home’. Continue reading
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.
I 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
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.
Do 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!
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 attended the East Midlands Dementia Day on 6 December 2016. She tweets at @lizcharalambou and is a regular guest blogger for the BGS. Opinions expressed in this blog are solely Liz’s own and do not express the views or opinions of her employer or any other organisation.
The East Midlands Dementia Day on 6 December 2016 at Nottingham City Hospital proved to be an inspiring and informative event. Organised by dementia specialists, Professor Rowan Harwood and Dr. Karen Harrison-Dening, the day welcomed expert speakers from Nottingham and further afield.
The day began with Professor Rowan Harwood who presented an overview of dementia and its increasing importance from a public health and societal perspective. Painting the picture of the reality of dementia with stark statistics of multiple comorbidities; dementia in care homes and in hospital; and the reality of carer and family support for people with the disease, stressed the urgent need for further research. Continue reading
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.
On 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
Anna Davies is Policy and Research Manager at Independent Age.
As a charity supporting older people, we know that conversations about ageing and future care needs are often put off until times of crisis. In some ways this should come as no surprise – thinking about mortality and threats to independence stir up complex emotions for everyone. But we also know the impact of these missed conversations: in particular families struggling to make decisions around care or housing without being sure of their relatives’ wishes. And with more and more older people likely to be relying on family support in the future – one estimate suggests a 63% increase in the number of older disabled people receiving informal care by 2035 – this is not an issue that is going away. Continue reading
Simon Thomas is an Honorary Fellow of the School of Pharmacy, Keele University and a Director at Prescribing Decision Support – a Keele University spin-out company that delivers knowledge-based e-media systems designed to support healthcare decision making. Most recently, Simon has worked with NICE and Boehringer Ingelheim Ltd on the development of an innovative anticoagulation therapy decision support tool that assists patients and doctors in shared decision-making. Simon can be contacted at email@example.com
Falls and fall-related injuries in older people is a high-risk, high-cost problem. Notwithstanding the considerable human impact – distress, pain, injury, loss of confidence, loss of independence and mortality – falls account for the largest number of emergency hospital admissions for older people in the UK and cost the NHS over £2 billion each year. Continue reading
Mitsuko Nakajima (CMT1), Mary Ní Lochlainn (FY1), James Maguire (Registrar), Myuran Kaneshamoorthy (CT2), Jen Pigott (CT2), James Manger (CT2), Elizabeth Lonsdale-Eccles (CT2), Nivedika Theivendran (CT2), Laura Hill (CT2), Maevis Tan (CT2), Thomas Bell (ST3), Mark Lethby (CT2) & Alvin Shrestha (Clinical Fellow).
On February 6th-7th the BGS (British Geriatrics Society) Trainees Weekend took place in London. At one of the workshops, a group of us looked at how we can influence our colleagues to improve care for older people and also how we can conduct QI projects in non-geriatric settings. The workshop aimed to empower doctors who were not yet on a geriatric medicine training scheme to make a difference, especially where patients were unlikely to be seen by a geriatrician.
At the end of the workshop, the group put their heads together to come up with a Top 10 list, of things we can do to improve care for older people right now. Here are the results: