Why walk 500 miles when you can connect at G4JGlasgow?

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

Spring Speakers Series: Coroner’s Inquest

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

Arise, Geriatricians of tomorrow! – A specialty rising to meet the challenges of the modern NHS

Dr Vicky Gibson is an ST5 Geriatric medicine/ General Internal Medicine trainee in North-East England. She is secretary of the Association for Elderly Medicine Education (AEME), whose recent paper “Why Geriatric Medicine – a survey of UK specialist trainees in Geriatric medicine has recently been published in Age and Ageing. She tweets at @gibsonvmvicky

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

How to be a Delirium Superhero this World Delirium Day

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

MAPLE-V: Taking a collateral history for cognition

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.

mapleIt’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

Desperately Seeking Ethics: Reflections on attending a research ethics committee meeting

Liz Charalambous is a nurse and PhD student. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.

me-fbI 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

‘A journey of a thousand miles begins with a single step’: raising the status of care home nursing

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.

nursing-home-residentIt 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

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

East Midlands Dementia Day 2016

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. 

major-oak-sherwood-forestThe 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