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
I 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 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 →
The media’s portrayal of vulnerable elder people as ‘perpetrators of assaults’ shows us just how far we still have to go.
Dr James Woods is a registrar in Geriatric and General (Internal) Medicine in South East Scotland. He tweets at @jmwoods87
Earlier this week BBC Radio 5 Live ran a piece with corresponding BBC website article reporting on figures obtained from an NHS Protect report on physical assaults against NHS staff in England. The headline and corresponding analysis focused on patients over 75 years old as the most frequent ‘perpetrators of assaults’ against NHS staff. If you care about the healthcare needs of older people and want to see them treated with dignity and respect (which if you are reading this blog you probably do) then this makes for distressing reading. Continue reading →
Clare Bostock is a consultant geriatrician in Aberdeen. In this blog, she looks at issues around ‘date of birth’ and ageism.
It sounds very clichéd to say that I ignore date of birth, and it is not strictly true. I routinely check the date of birth of patients for two key reasons: identification, and as a test of cognition (4AT). The truth is, however, that I don’t think age is important and so I often don’t know how old my patients actually are!
In the patient list for the admissions unit – “acopia.”
In the nurse’s voice “Can you give her some lorazepam please?”
In the junior doctor’s tone “Another one admitted with falls. Nothing wrong with them.”
In the referral letter – “This lady has no (insert your own specialty here) -ological issues. Please could you take over her care”
Some healthcare workers do not enjoy dealing with older people. Part of me can understand why. It’s hard. Frail older patients place a lot of demands on staff. They need help washing and dressing. They need help with eating. They need help going to the toilet. They call out. They call out again. About the same thing you just reassured them about. And they don’t tell you what’s wrong with them. They come in “off legs” or confused, the same presentation hiding a multitude of diagnoses – from constipation to cord compression.
Dr Peter Wallis, formerly consultant geriatrician – Birmingham Heartlands Hospital, was involved with the filming of a new BBC 2 Documentary Series
The department of elderly medicine at Birmingham Heartlands Hospital became aware of the BBC‘s interest in a documentary series about the care of older people following an advertisement in the British Geriatrics Society Newsletter (2012) placed by the BBC Bristol Documentary team. The intention was to produce a 3 part documentary series reflecting current issues in the health and social care of older people. Following successful discussions and with the agreement of partner organisations including social services as well as primary, community, mental health and ambulance service teams, filming took place during 2012/13. Filming was centred around the elderly care and general wards as well as the A&E department at Birmingham Heartlands Hospital and the patients with their stories were followed into community settings.
Laura Izzard is an Specialty Trainee in Geriatric Medicine at Kings College Hospital, London
PANICOA – the Prevention of Abuse and Neglect in the Institutional Care of Older Adults – is a joint research initiative between Comic Relief and the Department of Health.
Published in December 2013, the PANICOA report ‘Respect and Protect’ draws together the findings of eleven individual research studies commissioned to examine the complex issue of mistreatment of older people in hospitals and care homes. It outlines three vantage points i.e. “narratives” reflecting the perspectives of residents and patients, care staff and care organisations. Themes emerging from the PANICOA Narratives were used by the authors to produce a number of recommendations intended to reinforce and/or improve current practice.
A new paper published online today in Age and Ageing argues that despite a year-on-year increase in the number of people over the age of 50 being diagnosed with the Human Immunodeficiency Virus (HIV), there is a reluctance of healthcare professionals to offer HIV tests to older people. This results in high rates of “late presentation” and therefore significantly increased mortality.
According to the article by Dr Eva Bunting and colleagues, of the Royal Sussex County Hospital, the proportion of older patients in the UK living with HIV has increased significantly. They quote the most recent Public Health England data, which shows that of an estimated 73,660 people living with HIV, in 2002 12% (3,640) were over 50 years old, while in 2011 that figure rose to 22% (16,550). In Brighton, where Professor Martin Fisher is based, this figure is as high as 35%.
There have been dramatic developments in HIV management since the introduction of combination antiretroviral therapy (cART) in 1996, but as the population of older people living with HIV increases, new challenges continue to emerge. Continue reading →
Zoe Wyrko is a Consultant Geriatrician at Queen Elizabeth Hospital Birmingham and is the workforce planning lead for the BGS. She tweets at @geri_baby
I like to think that as a jobbing geriatrician I have a fairly pragmatic attitude towards guidelines. I know that they exist, but I also know that they are not always directly applicable to a frail older person with multiple morbidities, so I’ll look at what they say with a hint of scepticism, and use them when they help me to provide the best care. Extrapolating from this, I tend to see NICE as an organisation that is more for other people than me. I know that the work they do is vital in standardizing care, bringing together groups of experts to decide on treatment pathways and helping to make decisions on which drugs to give when. I have even attended a stakeholder group for the preliminary stages of the guidance they are planning to issue for social care.