Stephen Lim is a Clinical Research Fellow and a Specialist Registrar in Geriatric Medicine in Academic Geriatric Medicine at the University of Southampton. His research interest is in physical activity and deconditioning in hospital. He will be speaking at the upcoming BGS Autumn Meeting in London. He tweets at @StephenERLim
Hospital-associated deconditioning is high on the agenda across hospitals in the UK and many hospital trusts have jumped on the ‘endPJparalysis’ bandwagon to encourage patients to get up and get moving, – and rightly so! It is encouraging to see that healthcare professionals and non-clinical staff members are increasingly aware that prolonged bedrest and immobility is bad medicine.
During an acute illness, older people are at risk of worsening sarcopenia and consequently a decline in physical function. The hospital environment, altered mental state, physiological stresses and poor nutrition (as a sequelae of the acute illness), are some of the important risk factors contributing to a loss of function. Continue reading →
A recent paper published in Age & Ageing, the scientific journal of the British Geriatrics Society, finds that current smoking in older people increases the risk of developing frailty, though former smokers did not appear to be at higher risk.
Smoking increases the risk of developing a number of diseases, such as chronic obstructive pulmonary disease (COPD), coronary heart disease, stroke and peripheral vascular disease, all of which can potentially have negative effects on people’s physical, psychological and social health.
Frailty is considered a precursor to, but a distinct state from, disability. Frailty is a condition associated with decreased physiological reserve and increased vulnerability to adverse health outcomes. The outcomes include falls, fractures, disability, hospitalisation and institutionalisation. Continue reading →
Professor Martin Vernon qualified in 1988 in Manchester. Following training in the North West he moved to East London to train in Geriatric Medicine where he also acquired an MA in Medical Ethics and Law from King’s College. In 2016 Martin was appointed National Clinical Director for Older People and Person Centred Integrated Care at NHS England. Here he discusses the 3rd National Frailty Conference which will be held on 28 September 2017 in Leeds. He tweets @runnermandoc
The 19th Century term ‘watershed’ refers to a ridge of high ground separating bodies of water flowing in different directions. With this in mind I believe the 3rd National Frailty Conference in Leeds this year truly does mark a watershed moment. It will provide a valuable and timely opportunity both to reflect and add clarity to the new direction of travel we are taking with routine frailty identification and intervention for older people on a national scale. Make no mistake: bringing frailty into the mainstream is game changing.
Over the last year I have been continually impressed by the enthusiasm, ingenuity and commitment around the country focused on improving care and outcomes for our expanding and ageing population. As a health and care system collectively we have much to celebrate from the hard work already done. Continue reading →
Professor David Oliver is a Past President of the BGS, clinical vice-president of the Royal College of Physicians, and a consultant in geriatrics and acute general medicine at the Royal Berkshire NHS Foundation Trust. Here he responds to Steve Parry’s recent BGS blog, The Frailty Industry: Too Much Too Soon? He tweets @mancunianmedic
Dr Steve Parry’s recent blog here, “The Frailty Industry. Too much too soon” certainly generated a great deal of hits and online responses. He is a well-respected geriatrician, has done sterling work for our speciality and we are friends in a speciality where solidarity and mutual respect are wonderfully the norm.
The more I reflect, the more I realise that none involved in the debate are a million miles apart in any case. We have all devoted our professional lives to the skilled multidisciplinary care of older people, especially those with the most complex needs; to the speciality of geriatric medicine; to the leadership of local services; to the education of the next generation of geriatricians and to developing the evidence base for practice. Continue reading →
Dr Shibley Rahman is currently an academic physician in dementia and frailty. His contribution on the diagnosis of behavioural frontal frontotemporal dementia, published while he was a M.B./Ph.D. student at Cambridge in 1999, is considered widely to be an important contribution to the field, even cited in the Oxford Textbook of Medicine. Here he responds to Steve Parry’s recent BGS blog, The Frailty Industry: Too Much Too Soon? He tweets at @dr_shibley.
In response to Steve Parry’s recent BGS blog, The Frailty Industry: Too Much Too Soon?, I would simply in this article like to set out some of the strengths and weaknesses in the conceptualisation of frailty, with some pointers about “where now?”
There is, actually, no international consensus definition of frailty (although there is one of a related term “cognitive frailty”).
In a world of fierce competition for commissioning, and equally intense political lobbying in health and social care, the danger is that a poorly formulated notion becomes merely a “Trojan Horse” for commissioning.
I must humbly depart from the views of some colleagues – for me, frailty is not just a word. I could likewise point to other single words which cause gross offence, which are unrepeatable in my blogpost here. Continue reading →
Steve Parry works in acute medicine and older people’s medicine. He has a special interest in investigation and treatment of falls and blackouts in adult patients of all ages. He is BGS Vice President – Academic and Research.
Fashions come and go, in clothing, news and even movie genres. Medicine, including geriatric medicine, is no exception. When I was a trainee, falls and syncope was the next big thing, pursued with huge enthusiasm by a few who became the many. But when does a well-meaning medical fashion become a potentially destructive fad? Frailty, quite rightly, has developed from something geriatricians and allied professionals always did to become a buzz word even neurosurgeons bandy about. No bad thing for all professionals who see older people to have awareness of the recognition and management of this vulnerable and resource intensive patient group. Continue reading →
Debra Quartermaine is a Qualified Nurse and currently works as the Falls Prevention Co-ordinator as well as the Dance for Health programme coordinator at Cambridge University Hospitals NHS Foundation Trust. Debra has experience of nursing in a variety of specialties including general medicine, care of the elderly, learning disabilities and mental health.
Thousands of emotions well up inside me throughout the day. They are released when I dance.- Abraham Lincoln
Since 2013, two pilot projects, funded through Addenbrookes Charitable Trust [ACT], and Addenbrookes Arts, involving weekly dance and movement sessions were run on elderly care, stroke rehabilitation and neuro-rehabilitation wards at Cambridge University Hospitals NHS Foundation Trust. An evaluation showed that the sessions enhanced wellbeing and health through supporting increased movement, more positive moods, and greater socialisation. Continue reading →
Population ageing remains a continuous challenge for health care providers due to the escalating number of patients with chronic conditions. This represents a considerable economic burden for health systems across the globe. Ever since its debut in the 80’s, prevention, early diagnosis, and treatment of human immunodeficiency virus (HIV) infection has captured the attention of the scientific community. Highly active antiretroviral therapy (HAART) radically modified the paradigm of living with HIV by prolonging survival and improving the prognosis of a previously terminal disease. Today, thanks to HAART, HIV is a chronic condition with a life expectancy similar to that of the general population and a significantly improved quality of life. However, the changes in survival for HIV infected individuals have unearthed the appearance at an earlier age of health problems that used to be observed exclusively in older adults. 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 Shibley Rahman is currently an academic physician in dementia and frailty. His contribution on the diagnosis of behavioural frontal frontotemporal dementia, published while he was a M.B./Ph.D. student at Cambridge in 1999, is considered widely to be an important contribution to the field even cited in the Oxford Textbook of Medicine. He has a passionate interest in rights-based approaches which he accrued as part of his postgraduate legal training. He tweets at @dr_shibley.