The GERIATRIC 5Ms – the 5 simple words every geriatrician needs to know (the new mantra)

Frank Molnar is a Canadian Royal College specialist in Geriatric Medicine who serves as the President of the Canadian Geriatrics Society and as the editor of that society’s Continuing Medical Education Journal. He tweets @FrankMolnarCGS

Those outside Specialized Geriatric Services have long had great difficulty understanding what specialists in Geriatrics do. We have contributed to this lack of clarity. As experts in complexity we often have difficulty communicating simply. In well-intentioned efforts to be inclusive and comprehensive we have employed long complex definitions that few outside our field can understand much less recall.

How often have you heard “what do you geriatricians really do?” Are you tired of explaining and re-explaining yourself? Are you looking for a better way to explain and sell our specialty? Continue reading

Comprehensive Geriatric Assessment and the role it plays in improving care delivered to the older person

Dr Diarmuid O’Shea is a Consultant Geriatrician at St Vincent’s University Hospital Dublin, and Clinical Lead for the National Clinical Programme of Older People in Ireland.  

Ms. Carmel Hoey is a Nursing & Midwifery Planning and Development Officer at the NMPD Unit, Galway, and HSE Service Planner for the National Clinical Programme of Older People in Ireland. 

Countries around the world are seeing significant growth in the numbers of people living longer and healthier lives. We all need to reflect proactively on how we can best maximise the intergenerational benefits this will undoubtedly bring and we must also address the challenges it will generate.

Ireland is no different, with a substantial growth evident in our older population. The number of people aged over 65 years increased by 14% between 2006 and 2011. An increase of 17% is predicted between 2011 and 2016, and a further 17% is expected by 2021 (Central Statistics Office, 2013). Continue reading

Is it time to redefine old age?

Vedamurthy Adhiyaman is a geriatrician working is North Wales. Here he discusses why we should redefine old age. He tweets @adhiyamanv 

Western literature arbitrarily defines old age as people above the age of 65 (Oxford textbook of geriatric medicine, Wikipedia etc). Few authors subdivide old age further as young old (65-74), old (75-84) and old-old (85+). This would make our reigning monarch ‘old-old’ and the next in line to the throne and our patron, old (not sure whether he would like to be called old…). And definitions of old age vary according to different parts of the world. For African countries, the United Nations set the age 60+ and the WHO defines 50+ as old. Dictionaries define old age as a later part of normal life without defining any numbers. Continue reading

Autumn Speakers Series: Ageing and economic growth – not all doom and gloom?

Baroness Sally Greengross is Chief Executive of the International Longevity Centre – UK and has been a crossbench (independent) member of the House of Lords since 2000. She Co-Chairs four All-Party Parliamentary Groups: Dementia, Corporate Social Responsibility, Continence Care and Ageing and Older People. She was awarded a Special Lifetime Achievement Award at the BGS 70th Anniversary Reception on 6 March 2017.  She will be speaking at the upcoming BGS Autumn Meeting in London.

What are the economic and societal effects of a global ageing society and the increasing need for a healthy older population who will be employed into their 70s? 

Firstly it is worth saying that ageing and economic growth – is not all doom and gloom? Population ageing is a global phenomenon. The rate of growth in older people (people aged over 65) is expected to far outpace the rise of the working age population (people age 15-64). The old age population will grow by more than 300% over the course of this century by comparison with the working age population which will grow by less than 50%. Continue reading

Geriatric co-management: where is the evidence?

Bastiaan Van Grootven is a PhD researcher at the KU Leuven – University of Leuven in Belgium. His paper Effectiveness of in-hospital geriatric co-management: a systematic review and meta-analysis has recently been published in Age and Ageing. He tweets at @accentvv

Hospitals have long been recognized as a hazardous environment for frail patients. To date, care is still sub-optimal: cognitive and functional problems are not recognised or treated properly and patients are at high risk for delirium and functional decline. In our study, we reviewed 12 experimental studies to evaluate if geriatric co-management can improve outcomes for older in-patients. Co-management was defined as a shared responsibility and decision making between a medical doctor (e.g. surgeon) and geriatrician (or geriatric team) aiming to prevent and treat geriatric complications. Continue reading

The struggle for age-proof medical care in the Netherlands

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

Half the people in the world with Parkinson’s Disease have probably not been diagnosed – yet…

Richard Walker is a Consultant Geriatrician at North Tyneside General Hospital, and Honorary Professor of Ageing and International Health at Newcastle University. He has a research interest in non-communicable diseases in sub-Saharan Africa (SSA) and is Associate International Director for SSA for the Royal College of Physicians, London. He is the Clinical Lead for the Northumbria / Kilimanjaro Christian Medical Centre health link and Chair of the Movement Disorders Society African Task Force. In this blog article he discusses the growing challenge of Parkinson’s Disease in SSA.

I’ve recently got back from the 21st International Congress of Parkinson’s Disease (PD) and Movement Disorders in Vancouver where I chaired the African Task Force meeting. At the congress it was exciting to hear about all the new developments in the field, but it was perhaps unsurprising that there was very little research about the treatment of PD in lower and middle income countries (LMICs). Continue reading

Frailty among older persons living with HIV: a new burden for their clinical care

Alfonso Zamudio-Rodriguez holds a master’s degree in Public Health and is interested in frailty of older persons living with HIV. He develops his work in the department of Dr. Ávila-Funes @geriatriainnsz at the National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City.

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

Autumn Speakers Series: What is geriatric rehabilitation? Towards a unifying concept

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

Autumn Speakers Series: A glimpse into the future of acute care for older people; innovation, connectivity, transformation

Professor Roger Wong is Executive Associate Dean, Education in the Faculty of Medicine, University of British Columbia (UBC). He is a consultant geriatrician at Vancouver General Hospital, where he founded the Acute Care for Elders (ACE) unit that is replicated across Canada and internationally. He tweets at @RogerWong10 and is a key opinion leader in geriatrics and ageing. In this blog article he discusses the determinants that can transform the future of acute care for older people. He will be speaking at the upcoming BGS Autumn Meeting in London.

For all of us who work with seniors in the hospital setting, we often wonder what the future holds for acute care for older people. While our crystal ball may appear blurry on some of the exact details, we can certainly take a sneak preview now on three determinants that can change and shape the future of acute care geriatrics.

First, disruptive innovation in the medical sciences has already begun to transform the delivery of healthcare in seniors. Take cancer for example, which affects a significant number of older people every year. Continue reading