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 →
Dr. Susan Freter is an Associate Professor of Medicine at Dalhousie University, and a staff geriatrician at the Nova Scotia Health Authority in Halifax, Canada. She has a special interest in delirium prevention and management in orthopaedic patients.
Geriatricians talk a lot about post-operative delirium. It is common after surgeries, especially in people with a lot of risk factors (or we could say, especially in the presence of frailty), and even with recovery it makes for a bad experience. The occurrence of hip fracture, which mostly befalls patients who are older and frail, demonstrates this routinely. We know that taking extra care with at-risk patients can help to prevent delirium. Taking extra care can manifest in different forms: educating the caregivers, paying attention to hydration (is the patient actually drinking the cup of water that is plonked down in front of them?), paying attention to constipation (preferably before a week has gone by), making sure hearing aids are in the ears, and using medication doses that are geared for frailty, rather than for strapping 20 year olds. But how can what we talk about be translated into what we do? Does the ‘doing’ actually work in practice? Continue reading →
Sarah Blayney is a Clinical Fellow in the Calgary Stroke Program at Foothills Hospital, University of Calgary. She received a BGS SpR Travel Grant to help fund her fellowship.
As the branch flicked back and caught me full in the face, I saw another coming from the side just in time to throw my weight left and precariously low over the horse’s neck. We had left the trail some time ago after encountering more fallen trees after last week’s snowstorm; the temperatures had soared to the high twenties again but this far out into the mountains there was no one around to clear the trail. Narrowly avoiding my leg being crushed against a tree as we forged our own path through the undergrowth, I wondered quite what I’d let myself in for this weekend. The initial natural obstacles encountered on the lower level trails were nothing in comparison to those up here, and the gradient was punishing for both us and the horses.
Eventually we broke the tree line and took in a spectacular view of the valley below. Any breath left was soon gone after struggling up the last section: so steep here that we were out of the saddles and down onto our feet. After three hours of hard riding my legs were
in no shape to clamber up a rocky outcrop while trying to persuade several hundred pounds of horseflesh behind me to wait his turn, but a few minutes later I sank gratefully onto the coarse grass at the top. Once up there our horizon broadened further, taking
in the mountain ranges to the north and west. Far in the distance, a hunter’s rifle fired periodically and the echo bounced around the mountains for several seconds each time. It was the hardest and most exhilarating riding I’d ever done, and the view from the
top was outstanding.