Dr Shibley Rahman is an academic physician interested mainly in dementia and frailty. He tweets at @dr_shibley
My most recent experience of delirium was truly terrifying, to the point that, as a care partner of a close relative with dementia experiencing delirium, I felt I needed counselling about this admission to a London teaching hospital.
I have now witnessed delirium ‘around the clock’ for half a month so far.
Delirium research is not taken as seriously as it should be.
Where for example is the research which explains the neural substrates of hypoactive and hyperactive delirium? How long do ‘sleep episodes’ last for? Is it a good idea to wake someone up while he is sleeping? Are there are any neuroprotective agents which prevent long term deterioration after delirium? How much of the delirium will the person experiencing it actually remember? Continue reading →
Professor Martin Green OBE has had an extensive career in NGO development, both in the UK and internationally, and is Chief Executive of Care England, the largest representative body for independent social care services in the UK. He will be speaking at Living and Dying Well with Frailty event on 6 March. Follow the conference on the day via #bgsconf
We have now got a Department of Health and Social Care, what a difference that is going to make (I said sarcastically). With increasing regularity, the Government seems to think that messing about with the headed paper is a route to change. How much evidence do they need that changing titles and rejigging the logos is not going to deliver the transformational change that is required in order to deliver the route map to integrated services. If we had spent one tenth of the money we have spent on new titles, new structures and new logos on culture change, we would be in a far better position than we find ourselves today and the integrated services that citizens are crying out for might be a more attainable goal. Continue reading →
Fran Kirkham is an F2 doctor at the Royal Sussex County Hospital in Brighton, having graduated from the Cambridge Graduate Course in Medicine in 2016. She originally did an English degree at Cambridge University and worked in PR and Communications for 7 years. She hopes to pursue a career in Community Geriatrics.
“So we drove on toward death through the cooling twilight.”
~ The Great Gatsby, F. Scott Fitzgerald
An FY2 taster week can have a multitude of meanings. For some, it offers a reprieve from their mundane day job, almost as desirable as annual leave. For others, it is an opportunity to try a specialty that piqued their interest as a student. Yet others use it for cynical CV-building, knowing exactly to what profession they aspire and ‘proving commitment’ by spending an extra week doing the job they plan to do for the next 40 years. This may gain marks on the flawlessly-designed points-based applications which determine our chances of working in a specialty that bears any resemblance to our future career hopes or a location which is vaguely practical. Of course, a week is not realistically enough to get a sense of any job, nor ‘prove’ commitment to anything. But, as with many things in the NHS, this is the system in which we operate, so we make the best of it. Continue reading →
David Scott is a 78 year old retiree from Teacher Education with type 2 diabetes and heart failure. In retirement he has developed a strong interest in patient engagement issues. These are engaged with via the Alzheimer’s Society, NiHR (specialist group on Ageing) Age UK and the Stem Cell Bank. He attended the BGS Autumn Meeting 2017 as a patient representative. Register for the BGS Spring Meeting, 11 – 13 April at NCC in Nottingham.
How was your BGS Autumn Meeting 2017? I enjoyed meeting a lot of people with plenty of experience and don’t the Geriatricians look young these days! Remember that I am 78 years plus. What about that location? Very intimidating on first arrival but once in your allocated space, superb facilities. Plenty of toilets, plenty of overall space, good catering – with alternative if you didn’t mind going a bit further. Found the steps down between levels quite hard but recognise the need to do your daily exercise! One or two smaller rooms got a bit crowded for some presentations but, in general, presentations well supported. Continue reading →
Bridget Leach has been a nurse for over 30 years. She currently work in falls prevention but was also a ward nurse and ward sister for many years.
LOST: Sense of humour OWNER: NHS Reward for return: happier, healthy & retainable workforce.
The above may seem flippant but a simple google of the term ‘Do hospital managers have a sense of humour?’ returned a myriad of articles including academic research.
Some of the articles were what I would consider odd; for example; a member of hospital staff doing tricks with disappearing scarves while …”the surgeons began cutting away dead flesh …” to a ‘humour cart’ containing, amongst other things, ‘funny props’; I know plenty of hospital staff who, in certain circumstances, would consider a bedpan on the head and a proctoscope a funny prop so who knows? Continue reading →
In 2013 Professor David Oliver wrote a blog, the Geriatrics “Profanisaurus”, a list of words and phrases that should be banned, he encouraged other ‘BGS-ers to join in the fun and add their own “unutterables”.
My contribution to this list is some frequently encountered diagnoses that should be approached with scepticism.
‘Bilateral cellulitis’: If both legs are infected then the person should be unwell. Usually red legs are caused by a combination of underlying pathology; acute lipodermatosclerosis, venous hypertension, venous stasis dermatitis, lymphoedema or panniculits. The legs are hot and swollen but in the context of someone who is afebrile with minimal inflammatory response. The reason they are not responding to antibiotics is because they do not have an infection. Continue reading →
Dr Shane O’Hanlon is a consultant geriatrician and Honorary Secretary of the BGS. He holds a law degree and has a special interest in medicolegal matters. He tweets @drohanlon
Most doctors spend their career hoping never to see the inside of a courtroom! While geriatricians are probably among the most rarely sued specialists, we can still have quite frequent involvement with the law – the Coroner’s Court is a good example. There is also an increasing amount of medicolegal work related to dementia, deprivation of liberty safeguards and mental capacity. In this environment there has been a gap in the market for a book that focuses specifically on our needs, but retired geriatrician Dr Geoffrey Phillips is at hand with help.
“The Geriatrician in Court” is a handbook of “how to do it” based upon his thirty years of experience in preparing medico-legal reports and attending court to give expert evidence. The book covers all the main topics over the course of 226 pages. It begins with an outline of the legal system, criminal versus civil law, negligence and burden of proof. Important areas such as mental capacity, testamentary capacity, abuse, medical error and resuscitation all feature. Continue reading →
Beverley Marriott is an Advanced Nurse Practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s CollegeOlder Person Fellow. She tweets @bevbighair
Nationally there is increasing recognition of the needs of frail older people in health systems, and the UK’s rapidly ageing population will only increase in the years to come.
Dr Ram Byravan (Consultant and Clinical Director Heart of England Elderly Care) states that the prevalence of multimorbidity is on the rise, with 44% of people over 75 now living with more than one long-term condition – geriatricians and GPs are uniquely suited to lead the response to the challenges of caring for this group.Continue reading →
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 →
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 →