How can hospitals empower older people with advanced disease?

Dr Lucy Selman is Cicely Saunders International Faculty Scholar in the Department of Palliative Care, Policy, and Rehabilitation at King’s College London, and a Research Fellow at the University of Bristol. In this blog Lucy discusses her recent Age and Ageing paper on an international study of patient empowerment in hospitals in London, Dublin and San Francisco (part of BuildCARE, a project led by Prof. Irene J. Higginson at King’s College London).

superheroEmpowered patients adopt healthier behaviours, use health services more cost-effectively, and experience better quality of life than patients who feel they are passive recipients of healthcare. Across the developed world, policy-makers are waking up to the benefits for patients and health services when people are encouraged to engage with clinicians, make decisions and manage their illness in a way that reflects their own values. Continue reading

Wrinkly hands or ‘cocaine ‘fro’? You decide…

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 is currently a PhD student at The University of Nottingham. She tweets at @lizcharalambou and is a regular guest blogger for the BGS. Her blogs are her own opinion and do not represent the opinion of her employer or any other organisation.

grandmaI came across a USA you tube clip the other week which challenged my thinking on HCOP care. The footage was of a young man who has teamed up with his grandma to make, what I would describe as ‘stereotype-busting videos’ of his visits to see grandma in ‘the ‘hood’. I initially thought it was controversial and mildly exploitative (after all he talks to his grandma about her ‘cocaine ‘fro hairdo). I had to watch them a few times to decide that actually, this challenges my perceptions of how we engage with older people. Watching grandma rolling meatballs to ‘roll out’ rap music and shimmying her shoulders following a successful bottle flip challenge, I was hooked. The couple do Q & A sessions, mannequin challenges and twerking dance offs, cover naughty topics, and cause general mayhem and shenanigans at a pet store, among other (more saucy) clips, and seem to have a great deal of fun together in the process.

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

Getting to grips with multimorbidity and polypharmacy for older people

Dr Kevin Mc Namara is a Senior Research Fellow at Deakin University’s School of Medicine and Centre for Population Health Research. He has a particularly interest in the implementation of models for chronic disease prevention and management, including the management of multimorbidity. His paper, Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia, has been published in Age and Ageing journal.

aaResearchers from Australia offer some valuable insights about effective multidisciplinary care for older people who often have multiple health conditions (multimorbidity) and take multiple medications (polypharmacy). In ageing populations across the developed world, multimorbidity and polypharmacy pose unique and growing challenges for health professionals and systems. Treatments and goals for different health conditions are often not compatible, guideline recommendations may not be feasible, the evidence often lacking for older adults, and health systems are not designed to coordinate the activities of multiple health professionals often involved with care. 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

International Day of Older Persons 2016

David Oliver is the current 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. He tweets @mancunianmedic

older-e1467720187191I am delighted that October 1st sees the International Day of Older Persons and looking forward to all the activity that should go with it – in local communities, in public services and charities and in mainstream and social media. I also welcome the themes this year – highlighting and tackling ageism and celebrating older people. Continue reading

Esther Clift’s African Blog Series; Part 3 ‘Palliative care’

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

estherThe scourge of AIDS in the 1990s led to the introduction of palliative care as both a medical speciality in symptom management and a community initiative to support people at the end of their lives to live at home with their loved ones. Communities identified and trained community carers to offer practical support for activities of daily needs. Some palliative care facilities were developed, particularly in Uganda where AIDS was rife, and the government and NGOs were particularly proactive in both prevention measures and care, as both centres of training and excellence, as well as hospice care. 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

Esther Clift’s African Blog Series; Part 1 ‘Superstition’

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

Evidence of superstition is everywhere in Nairobi. The lampposts are plastered with posters of a certain ‘Doctor’ offering help with relationships, ‘manliness’, and money issues. On payment of a significant sum- starting at about £30, and upwards, various incantations, and ‘luck’ potions are generated and taken. The internet is full of stories of how people’s situations have changed immediately after taking their potions, or using incantations, such as ‘I was immediately able to clinch the deal which had been hanging around for months’, and so on. Continue reading

Translating Isaacs

Professor Kenneth Rockwood has published more than 300 peer-reviewed scientific publications and seven books, including the seventh edition of the Brocklehurst’s Textbook of Geriatric Medicine & Gerontology. He is the Kathryn Allen Weldon Professor of Alzheimer research at Dalhousie University, and a staff internist and geriatrician at the Capital District Health Authority in Halifax in Canada. 

chinaIn May 2016 I was honoured to speak about frailty at the Chinese National Geriatrics Conference in Beijing. The audience, not just geriatricians, was people who care for frail older adults. They recognized in geriatric medicine the tools and concepts needed to improve the care of those patients.

For that reason I found myself discussing how best to translate the great Bernard Isaacs’ nicely alliterative phrase “Geriatric Giants. In The Challenge of Geriatric Medicine (Oxford: OUP, 1980) Isaacs elaborates them, also alliteratively, as “instability, immobility, incontinence, intellectual impairment/memory and impaired independence”. These were key ways in which patients and their families understood that “something was wrong”. Continue reading