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

The British Geriatrics Society welcomes plans for strategic approach to funding of care for older people

The British Geriatrics Society welcomes yesterday’s announcement in the Chancellor’s Budget Statement that the Government will be publishing a Green Paper this year on the future financing of social care. We have been calling for a lasting solution to the current crisis and are pleased that there is a clear recognition of the need for a sustainable and strategic approach to the funding of care for older people.
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The UK versus the Netherlands: Where would you want your grandmother to be looked after?

Barry Evans and Rachel Cowan are Specialty Trainees in Geriatric Medicine currently working as Clinical Fellows in Quality Improvement for Integrated Medicine in the East Midlands. They recently had the opportunity to undertake an exchange with Anouk Kabboord – Elderly Care Physician trainee in the Netherlands.

dutchAt a time when the European narrative is being rewritten, a common challenge facing all European nations is population ageing. Seeing and learning from different European countries’ responses to an ageing population is an invaluable opportunity to learn, discuss and share innovation between countries. As part of Health Education East Midlands’ Quality Improvement Fellowship, we were recently able to set up an exchange between the UK and the Netherlands for geriatricians in training to see and learn from each other’s working environments. Continue reading

A New Holistic Approach to Pain Management in Older People

Nan Ma is specialist registrar in clinical Gerontology and Aza Abdulla is a consultant geriatrician and general physician at the Princess Royal University Hospital, Kings College NHS Foundation Trust. He is co-founder of the Special Interest Group on Pain in Older People in the British Geriatrics Society (BGS) and participated in producing the first National Guidelines on Management of Pain in Older People. He is also the immediate past president of the Geriatrics & Gerontology Section at the Royal Society of Medicine.

painPain in older people is under-reported and often poorly appreciated. For many, it is seen as part of normal ageing and has to be accepted. It is also a subjective feeling (different people have different pain thresholds) making it difficult for the clinician to quantify its impact in an individual patient. Consequently, it may be overlooked as an important factor that can affect older people’s wellbeing. In fact, chronic pain has a huge influence on quality of life (QoL) through its effects on the physical and mental state, which in turn adversely impacts on the older individual’s economic and social status (effects on carers, friends and family). Inadequately controlled pain perpetuates disability, anxiety, and depression all interfering with the overall QoL. It follows that effective management of pain is crucial in optimising welfare in the older person. Continue reading

Global Summit on Aging and Health- personal reflections on a conference and a cultural exchange

Dr Eileen Burns has been a geriatrician in Leeds since 1992 and is President of the BGS. She is currently Clinical Lead for integration in Leeds and Chairman of the BGS Community Geriatrics Special Interest Group. She tweets @EileenBurns13

chinaI was fortunate enough to attend and speak at a Global Summit on Aging held in Shanghai recently. It was a fascinating event, with speakers from an enormous variety of backgrounds- from the US Embassy in Beijing, the World Health Organisation, and the United Nations Population Fund, as well as numerous Chinese Government office holders.

The summit was jointly organised by Columbia University, USA (under the auspices of the wonderful Professor Linda Fried) and Fudan University in China. Continue reading

NHS – A giant Diogenes syndrome

Adhi (V Adhiyaman), geriatrician and Chair of Welsh council of the BGS. Tweets at @adhiyamanv

220px-giovanni_battista_langetti_-_diogenesDiogenes was a controversial Greek philosopher who lived in the fourth century BC. He was a cynic and rejected many conventional ideas and lived in a large clay jar in the city of Athens. He lived in a squalor and rejected ideas of normal human decency.

Diogenes syndrome is a disorder characterized by self-neglect, domestic squalor, apathy, compulsive hoarding of garbage and more importantly lack of shame. The syndrome does not refer to the intelligence or the philosophies of Diogenes but rather refers to the way Diogenes lived. A person with primary Diogenes syndrome is intelligent but aggressive, stubborn, suspicious, emotionally labile and has an unreal perception of life. Continue reading

An overview of the Policy Forum for Wales event

Hospital in Bridgend, Wales. He is a care of the elderly physician with an interest in Parkinson’s Disease and movement disorders.
flag_of_wales_2-svgOrganised by the Policy Forum for Wales, this event which was held on 19 October, provided the Welsh Government, and other agencies, the opportunity to engage with key stakeholders and discuss public health policy issues that particularly affect Wales. This seminar was about involving health and social care senior policy makers in developing a vision for Wales and bringing together multiple organisations (public sector, voluntary and third sector) to have a dialogue about how best to influence the Welsh Government’s health and social care policies.

The day was kicked off by chair Mr Huw Irranca – Davies AM, with a cross party group on cancer introducing the theme of the day. This was followed by brief from Professor Siobhan McClelland on current trends in health care in Wales including a £700 million gap in the budget for health and social care (10% of the total health budget). She emphasised that service configurations should be decided according to local need rather than by committee or Government mandate. Continue reading

Esther Clift’s African Blog Series; Part 4 ‘Healthy ageing’

Esther Clift is a Consultant Practitioner Trainee in Frailty with Health Education Wessex. This is the final part of a four part BGS blog series about her time in Africa. She tweets @EstherClift

healthy-ageing“Healthy ageing” is defined by the World report on ageing and health as the process of developing and maintaining the functional ability that enables well-being in older age.

What does that look like in developing countries?

I have had the privilege of travelling through some of Kenya and Uganda and I asked how people view their prospects, as they grow older. Some like Nathani in rural Jinja, Uganda, a retired academic and researcher with a PhD from Strathclyde University felt that his future was tied up in his land, and his children. He had both, and at 74 was fit and well, and held in high esteem by his community. He described his children as his wealth. Continue reading

Esther Clift’s African Blog Series; Part 2 ‘The concept of Mzee and Heshima’

Esther Clift is a Consultant Practitioner Trainee in Frailty with Health Education Wessex. This is the second part of a four part BGS blog series about her time in Africa. She tweets @EstherClift

estherIt is well recognised that in much of East Africa the concept of ‘Heshima’ or respect for ‘Wazee’ is still widely practised. The term “Mzee” describes an older person, often with greying hair, but has a tone of respect and deference to it. I heard the term used widely, from young white men joshing their father, to students upholding a faithful teacher, but always with a tone of love and respect. There is no direct translation into English were our language for ageing is often loaded with a derogatory tone and disliked by one group or another. Phenomenology is a challenge we are all too familiar with in Medicine for Older People! We often refer to such expression as an example of how Western cultures need to learn from those of the global South. Continue reading

Which one is a better deal – home visits or phone calls?

Frances Wong is a professor at the Hong Kong Polytechnic University. telemed

Our recent research has revealed very interesting findings about the power of a telephone call as compared to home visits for post-discharged patients. Patients are discharged from the hospital as soon as the immediate problems are resolved. Some care issues only emerge when the patients return home. The issues usually involve patients’ confidence and ability for self-care, symptom management, adherence to medication regimen and so on. If these concerns are not addressed properly, the patients will present themselves to the hospitals again. Like a revolving door syndrome, patients returning to the community come back to the hospital within a short time. The mean readmission rate within 28 days after discharge is 15% and the rate can escalate to 35% for the chronically ill patients.  Continue reading