We must do more to ensure no-one misses out on rehab

Professor Karen Middleton is Chief Executive of the Chartered Society of Physiotherapy. Karen is a Fellow of the Society of Orthopaedic Medicine, and, in that capacity, has taught physiotherapists and GPs on a national and international basis. Here she discusses the report Recovering after a hip fracture:
helping people understand physiotherapy in the NHS.

It’s the overwhelming feelings of regret and loss that get me. Every time. Whenever I hear a family member say they ‘can only wonder what might have been’ or a patient talking about what they can no longer do.

Whenever I see our Rehab Matters film I know that the fictional story it depicts is playing out in real life, behind closed doors, in homes across the country. It cuts deeply, as a physiotherapist, to hear these stories of how a lack of access to rehabilitation has changed a life.

It makes me burn at the injustice of so many people missing out. Because I know how access to high-quality rehabilitation can change a life for the better – how it can return a person to the things they love, and to the things they do with the people they love. How it can restore independence and a sense of self-worth. How it can restore a life; how it can save a life.  Continue reading

Making the most of our assets

Beverley Marriott is an Advanced Nurse Practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s College Older Person Fellow. She tweets @bevbighair

The Reimagining community services report (Kings Fund 2018) highlights the need for strengthening community services with the aim of supporting our  older population, bringing to reality the vision set out in the NHS Five Year Forward View.

Unfortunately, the concept of reimaging services brings about concerns with growing financial and workforce pressures, these pressures could have a huge effect on the delivery of the recommendations. This could have a major impact on the ability of service providers to deliver services to meet the needs of the service user.

The Reimagining Community services report suggests that radical transformation of community services is required.  This would mean an additional share of the NHS budget. The NHS budget would be given to these services in order to make effective use of all the assets with our community.  Continue reading

The British Geriatrics Society calls for urgent action on hunger and malnutrition among older people

The British Geriatrics Society welcomes the recently published report by the All Party Parliamentary Group (APPG) on Hunger. The report highlights that malnutrition is most likely to arise among older people following an accumulation of setbacks – for example bereavement, illness, a loss of community transport services, and a nearby shop closing,  – which leave them unable to access food easily.

Geriatric medicine has always recognised the importance of nutrition and sufficient intake of food and fluid in patient care. We hope that as a matter of urgency Government will seek to address the recommendations from the APPG so that malnutrition in older people, and those at risk of malnutrition, is identified and treated as quickly as possible. Continue reading

Number of older people with four or more diseases will double by 2035, say researchers

A study published recently in Age and Ageing, the scientific journal of the British Geriatrics Society, reports that the number of older people diagnosed with four or more diseases will double between 2015 and 2035. A third of these people will be diagnosed with dementia, depression or a cognitive impairment.

The study, conducted by researchers at Newcastle University’s Institute for Ageing, found that over the next 20 years there will be a massive expansion in the number of people suffering from multiple diseases, known as multi-morbidity. As a result two-thirds of the life expectancy gains, predicted as 3.6 years for men, 2.9 years for women, will be spent with four or more diseases. Continue reading

Qualitative Research in Age and Ageing

This themed collection of Age and Ageing articles includes a selection of papers published over the last 10 years which highlights the value of qualitative methodologies in health services research, particularly in understanding patient experience of health and illness and decision making about treatment and preventive care. We hope this issue will raise awareness of the scope for further contributions and encourage authors to submit papers reporting qualitative studies to the journal.

Summary of topics and themes:

In an editorial in Age and Ageing (5), we drew attention to the way in which the application of qualitative research methods within the social science disciplines of sociology, anthropology and social psychology can enrich understanding of ageing and illness: for example, through eliciting the meaning and process of ageing, health and illness from the perspective of older people; the practice of service delivery and what shapes it; and the beliefs, values and ‘taken for granted ‘knowledge that professionals may apply in their work with older people. Continue reading

Comprehensive Care – NIHR themed review of research into older people with frailty in hospitals

John Gladman is Professor of the Medicine of Older People, Division of Rehabilitation and Ageing and Honorary Consultant in Health Care of Older People at Nottingham University Hospitals NHS Trust.

Vast sums are spent on research into the care of older people, but they are wasted if the findings are not put into practice.

I had an epiphany a few years ago. I looked at my carefully curated curriculum vitae, and noted that I had over 100 peer reviewed papers to my name. But I suddenly felt deflated when I realised that hardly anybody (apart from the journals’ editors) had ever read them. Deflation was followed by shame as I realised that I had made no effort to disseminate my findings to those who might find them useful, or to encourage the application of the findings in practice. I recovered a bit when I realised that it wasn’t just me. There is a real problem as the amount of research being published is monstrously huge. But I returned to shame again when I thought about how little effort I have taken to ensure that I keep up to date with other people’s research. Continue reading

Spring Speakers Series: Asthma in the older patient

Dominick Shaw is an Associate Professor and honorary clinician at the University of Nottingham and Nottingham University NHS Hospital Trust. He leads the commissioned severe asthma service and performs clinical studies in asthma. He will be speaking at the upcoming BGS Spring Meeting in Nottingham.

Asthma still presents a major challenge to society. Although classically regarded as a disease of children and young adults, accumulating evidence suggests that late onset asthma carries a poorer prognosis. Moreover although the death rate from asthma has fallen over the last 10-15 years in people under 75, in those aged over 75 it has doubled. Consequently the overall mortality rate has not changed.

Asthma still causes significant social and financial problems for patients, with recurrent exacerbations needing oral steroids, hospital admissions, time off work and impact on families and carers. There is light at the end of the asthma tunnel however and asthma has advanced a long way from, in the words of a geriatrician colleague*, “one puff of the blue, two of the brown”. Continue reading

Taking control of our homes as we get older

Dr Rachael Docking is Ageing Better’s Senior Evidence Manager. Rachael’s remit is to work on their evidence work stream and manage one of their programmes of work, as well as providing cross-cutting evidence support to other work-streams. Rachael leads on their homes and neighbourhoods programme and has also been managing a commissioned review on inequalities in later life.

Jill is 68 years old. She’s still working and cares for her husband. With reduced mobility due to osteoarthritis, Jill has been in a lot of pain, living in a house that wasn’t suited to her changing needs and didn’t know where to turn to for help. She began to develop coping strategies like shuffling upstairs on her bottom, and couldn’t bathe or shower properly.

After a needs assessment from a local occupational therapist, Jill had a number of adaptations installed at home, including a wet room and extra stair rail. As a result she can now shower herself and though still in pain, the adaptations have helped her remain in her own home. Continue reading

A generation of Doctors unable to look after their patients?

Dr Anthony James is a Consultant Physician at Princess of Wales Hospital. 

There have been many changes in recent years. The patients are older with more frailty, multiple comorbidities and a mixture of social and medical issues. These patients are often described as ‘complex’, making them sound as if they are something special. The reality is that they are now the norm and everybody should be able to deal with the norm. These problems are recognised by Royal College of Physicians in Hospitals on the Edge? The time for action (2012);

‘All hospital inpatients deserve to receive safe, high-quality, sustainable care centered around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals. Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population and increasing hospital admissions.’ Continue reading

Book Review: Please tell me…

Liz Charalambous is a nurse and PhD student. She tweets @lizcharalambou and is a regular guest blogger for the BGS. Here she reviews ‘Please tell me…’ by Julia Jones and Claudia Myatt.

Without a doubt, one of the most important documents in older person care is the Alzheimer’s Society This is me support tool. It enables carers to access information with which to provide holistic care and is underpinned by a social model of care rather than a medical model, so important in today’s world of fast paced, pressurised, and increasingly politicised healthcare services. It places the person in the centre of care, ensuring their likes, dislikes, and preferences are recorded for the whole team to access.

Indeed, a favourite teaching strategy when introducing new students to dementia care is to provide them with two copies of ‘this is me’ and ask them to take them home for their partners or significant others to complete in the manner of ‘Mr and Mrs’ style 1970s TV programme. I have heard many stories of students returning the next day reporting back to the group that their other half had failed hopelessly in filling in the form, prompting them to realise the precariousness of ensuring person centred care in such instances. Continue reading