Wilco Achterberg (1963) is an elderly care physician and a Professor of institutional care and elderly care medicine in Leiden, the Netherlands. His research focus is on the most vulnerable elderly, most of whom live in nursing homes, and is centered around two themes: pain in dementia and geriatric rehabilitation. He tweets @wilcoachterberg
The Netherlands have been very fortunate to have had a very good insurance system for long term care, which provided good funding for nursing home care. That is why in a typical Dutch Nursing home you can find, next to nurses, therapists like physiotherapists, occupational therapists, psychologists, dieticians and even physicians. In 1989, a 2 year post graduate medical training program started, and ‘nursing home physician’ became an officially recognised medical specialism. The biggest challenge for Ageing Holland is not how to provide good care for older persons, but how to pay for that care. Therefore, for several years now government is trying to find other ways of caring for vulnerable and care dependent persons. Continue reading →
Romke van Balen is an Elderly Care Physician in Rotterdam and Senior Researcher in Leiden. His main field of interest is geriatric rehabilitation. He will be speaking at the upcoming BGS Autumn Meeting in London.
Although geriatric rehabilitation in most countries is considered to belong to the core tasks of geriatricians, there is no consensus about definition and target groups of patients.
Decades ago, the Boston Working Group defined geriatric rehabilitation as a multidisciplinary set of evaluative, diagnostic and therapeutic interventions whose purpose it is to restore functional ability or enhance residual functional capacity in elderly people with disabling impairments. When looking at this definition, one wonders if it separates geriatric rehabilitation from the general aim of geriatric medicine. Only palliative care clearly has another aim. Continue reading →
Dr Amy Heskett is a Speciality Doctor working in a Community Geriatrics team within West Kent called the Home Treatment Service. This team works alongside paramedics, GPs and district nurses to prevent unnecessary hospital admissions for people with frailty, multiple comorbidities, caring responsibilities or as part of end of life care. The home visits use bedside testing and a multi-disciplinary approach to provide management of many acute medical presentations in a home-setting. The development of these holistic plans requires a creative approach and the experiences often generate tweets @mrsapea and blogs at communitydoctoramy.wordpress.com
I read Roald Dahl’s ‘George’s Marvelous Medicine’ to my children today and my son said, “You really love the Grandma in this don’t you Mum?”
It’s true! It was one of my favourite books during my own childhood and I now spend a large amount of time perfecting the Grandma’s voice for my children and absorbing the story with them as they snuggle on the sofa. There is personal meaning to some of the pictures too and so a picture of George stirring the giant saucepan is hung on our kitchen wall. The text describes ‘A rich blue smoke, the colour of peacocks’, at which point we cheer because Peacock is our family name. Continue reading →
Dr Rajvinder Samra is a Chartered Psychologist working as a Lecturer in Health and Social Care at The Open University. She enjoys researching the influence of attitudes and personality in medical settings and tweets at @RajvinderSamra Read her Age and Ageing Paper.
Social psychologists have been interested in attitudes for about 90 years now. Debate rages on about how much of what we do can be predicted from our attitudes. No doubt, over the past year, you will have read newspaper articles about how much someone’s attitude to a prominent issue covered in the media predicted their likelihood to vote for Brexit or Trump. This is an example of the attitude-behaviour link and the media trying to establish patterns so we can understand society better. The influence of attitudes on healthcare are frequently overlooked, but doctors’ or patients’ cognitive reasoning, preferences, values and emotions (i.e. all the things that come together to make up attitudes) can have a significant and meaningful impact on how services can, or should be, delivered. Continue reading →
Cliff Kilgore is a Consultant Nurse for Intermediate Care and Older People within Dorset Healthcare NHS Trust and he is also a Visiting Fellow to Bournemouth University. He is Chair of the BGS Nurses and Allied Healthcare Professionals Council. He also is a member of the BGS Clinical Quality Steering Group. He tweets @kilgore_cliff
Many of our readers will know that the BGS has been at the forefront of promoting older people’s healthcare and wellbeing for many years. In fact, we celebrated 70 years of this in March. Leading the way for older people has enabled the BGS to have great influence on many aspects of policy and guidance including Fit for Frailty, The Silver Book, Comprehensive Geriatric Assessment (CGA), as well as ever increasing influence on training and development of all clinicians. The BGS has long recognised the importance of developing trainees and to support this has offered many benefits to its members including free membership for medical students and foundation doctors, study grants and sponsorship and support of research projects. Continue reading →
Being the medical registrar, or ‘med reg’, is recognised as being a tough job. The med reg is often considered to be the ‘go to’ person for the hospital at night – to shamelessly rip off a well-known 1980s TV show, “If you have a problem… if no one else can help… and if you can find them… maybe you should bleep… the med reg”.
The medical registrar is the senior training grade in medical training; effectively it’s the last stop on the road to becoming a consultant physician. Continue reading →
Dr Claire Copeland is a Consultant Physician in Care of the Elderly and Stroke Medicine, Forth Valley Royal Hospital, Larbert. She tweets @Sparklystar55
Back in 2014 Scotland was struggling to recruit trainees with 18% of training posts remaining unfilled. While Scotland may be the most beautiful country on the planet (#fact) it’s a vast and largely rural country. This is a unique selling point in some respects however there is the perception that it’s inaccessible and doesn’t have much going on compared to the more densely populated areas of say London, Manchester etc.
There is also the challenge of attracting people into the less ‘glamorous’ specialty that is Geriatrics. This problem isn’t unique to Scotland. A fact recognised by the team behind Association for Elderly Medicine Education (AEME). The founding members of AEME – James Fisher, Mark Garside, and Kelly Hunt recognised a need for high quality education for those delivering care to this older population. Continue reading →
Mr Leslie Hamilton recently took early retirement (pressure of the on-call transplant rota) as a cardiac surgeon but continues to sit as Assistant Coroner. He is currently on the Council of the Royal College of Surgeons and is a past President of SCTS (Society for C/Th Surgery). He will be Chairing a special workshop at the BGS Spring Meeting on Thursday 27 April.
You have just received a letter asking you to attend Court. You get a tachycardia. What is it about?
There are four courts which doctors can face in relation to their medical practice. It could be the GMC’s Medical Practitioners Tribunal Service (the old Fitness to Practice panels) – though strictly speaking it is a Tribunal rather than a court. It is however adversarial in nature with full legal representation. It could be in relation to a clinical negligence claim – in the civil court. An increasingly common occurrence in many specialties. Or very rarely it could be for the criminal court on a charge of wilful neglect or gross negligence manslaughter. Continue reading →
The Association for Elderly Medicine Education (AEME) was founded in 2012, by a group of trainee geriatricians with the aim of improving elderly medicine education and promoting uptake into the specialty. You can follow them at @elderlymeded
I’m still inquisitive when I hear more junior trainees spontaneously say that they want to do Geriatrics.
“Well, you know. Previously Geriatricians were in the shadow of the other -ologies – now everyone wants a piece of them when things get complicated with their older patients. They’re like the knights in shining armour.” Continue reading →
Hazel Miller, Consultant Geriatrician, Glasgow Royal Infirmary. Delirium enthusiast (or should that be delirium hater?) hoping she has earned the right to don a cape from time to time… Follow me on twitter @hazelmiller99
It’s fair to say that our understanding and management of delirium has increased hugely over the past ten years. It has gone from being the ultimate in Cinderella syndromes (unanticipated, undiagnosed, untreated, unexplained, unnoticed) to having high profile and energetic researchers and advocates (its own Delirium Superheroes). Everyone is being asked to Think Delirium these days. Continue reading →