The struggle for age-proof medical care in the Netherlands

Wilco Achterberg (1963) is an elderly care physician and a Professor of institutional care and elderly care medicine in Leiden, the Netherlands. His research focus is on the most vulnerable elderly, most of whom live in nursing homes, and is centered around two themes: pain in dementia and geriatric rehabilitation. He tweets @wilcoachterberg

The Netherlands have been very fortunate to have had a very good insurance system for long term care, which provided good funding for nursing home care. That is why in a typical Dutch Nursing home you can find, next to nurses, therapists like physiotherapists, occupational therapists, psychologists, dieticians and even physicians. In 1989, a 2 year post graduate medical training program started, and ‘nursing home physician’ became an officially recognised medical specialism.  The biggest challenge for Ageing Holland is not how to provide good care for older persons, but how to pay for that care. Therefore, for several years now government is trying to find other ways of caring for vulnerable and care dependent persons. Continue reading

Reflections on ‘NOT Forgotten Lives: Felixstowe 2017’

Liz Charalambous is a nurse and PhD student. She tweets at @lizcharalambou and is a regular guest blogger for the BGS. Here she reviews ‘NOT Forgotten Lives: Felixstowe 2017’ edited by Julia Jones and Bertie Wheen

‘NOT Forgotten Lives’ is a written record, produced for the 2017 Felixstowe Book Festival, which celebrates the lives of older people living locally in residential accommodation. This slim volume is organised by an overview of what life story work is about, followed by photographs and accounts of the life stories of residents living in nursing and residential accommodation in Felixstowe. It concludes with a personal reflection from the co-editor, Bertie Wheen.

Why is this book important?

In a world where dementia is on the increase there are political, economic, ethical and often personal reasons why society must wake up to the reality of the disease. Currently an estimated 50 million people worldwide live with dementia, with a forecast of 131.5 million by 2050.  In the UK there are 850,000 people living with the disease, estimated to increase to 2 million by 2050. These figures alone suggest that dementia is a disease which can no longer be ignored. Continue reading

Old People’s Home for 4 Year Olds

Dr Zoe Wyrko is a Consultant physician at University Hospital Birmingham and is the Director of Workforce for the BGS. In this blog she discusses the recent Channel 4 programme in which she appeared, Old People’s Home for 4 Year Olds. She tweets @geri_baby

I’ve always had a soft spot for care homes. As a child I would occasionally go into work with my Mum and meet some of the old ladies she talked about. When I was older I started work in the same nursing home as a kitchen girl on Saturdays, and then later progressed to health care assistant. I remain proud of my training record from that time, showing I am competent to deliver personal care, clean dentures and cut nails.

This is why I was excited when an approach came from CPL productions, who were looking for geriatricians to be involved with a television programme they wanted to make about introducing children to a care home environment. Continue reading

What does good look like when thinking about care homes?

Claire Goodman is Professor of Health Care Research at University of Hertfordshire. Claire has a district nursing background and is a NIHR Senior Investigator. Her research focuses on the health and social care needs of the oldest old, including those affected by dementia and living in long term care. She leads the DEMCOM study, an evaluation of Dementia Friendly Communities – @DEMCOMstudy @HDEMCOP

We have new neighbours. They moved three miles to improve their children’s chances of going to their preferred secondary school. If they had stayed put they would have been assured of getting a good state education. We are surrounded by Ofsted rated ‘good’ and ‘outstanding’ schools. The issue was that whilst it probably did not matter if their daughter went to a girls only or co-educational school, for their son, a boys only school, with a big focus on sport, would have been a problem. People in my local area know a lot about the schools, they know what the head is like, who the good teachers are, what extra-curricular activities are available and if it’s struggling with its budget. Continue reading

July 2017 issue of Age and Ageing journal is out now

The July 2017 issue of Age and Ageing, the journal of the British Geriatrics Society is out now.  A full table of contents is available here, with editorials, research papers, reviews, short reports, case reports book reviews and more.AA_46-03

Hot topics in this issue include:

  • Care home leadership
  • Physical restraint
  • Diet and muscle function
  • Prescribing for frail older
    adults
  • Treatment of overactive
    bladder

    The Editor’s View article gives an overview of the issue with a summary of highlights. This article is free to read and can be viewed here. Continue reading

    “Please remember I’m still a person!” A carer’s solution to help hospital staff provide person-centred and holistic care

    Zoe Harris cared for her husband at home before his dementia reached a stage where she was unable to cope, and he spent his final months in a care home. As a result of that experience, Zoe developed a range of communication tools to ensure that carers were aware of his needs and preferences, and which have subsequently been adopted by over 1,000 care homes and home care agencies. Her latest project is Mycarematters, an online platform where people, or someone on their behalf, can upload information to help hospital staff treat the whole person and not just their medical condition. @ZoeHarrisCCUK @Mycarematters @Care_Charts_UK

    When I look back, I think Geoff had been showing signs of dementia for at least eight years before his diagnosis, and it was only a matter of months after he was finally told that he had what was probably a mix of Alzheimer’s Disease and Lewy Bodies, that his condition took a turn for the worse. I had to admit defeat and he moved first to a dementia assessment ward and, three months later, to a care home for what turned out to be the final 13 months of his life. Continue reading

    The Challenges of Research in the Care Home Setting

    Annabelle Long is a Chartered Physiotherapist working as a Research Assistant at the University of Nottingham on a Dunhill Medical Trust funded PEACH study, which considers the role of Comprehensive Geriatric Assessment in UK care homes. She has a developing research interest in wellbeing for people with dementia in community environments. In this blog she outlines the potential challenges and solutions in doing research at the health and social care interface.

    As practitioners and researchers in care of older people, it is important for us to be continually working to include more dependent groups in research. The reason for doing so is to ensure that the evidence base can reliably be applied to the patients we see in everyday practice. However involving older people with dependency in research can be challenging because cognitive and physical impairments can make standard procedures for recruitment and data collection difficult. Continue reading

    Depression among older people living in care homes – a call for good practice examples

    Caroline Cooke is Policy Manager at British Geriatrics Society. Caroline is currently supporting a joint project being carried out by BGS and the Old Age Faculty at the Royal College of Psychiatry. Here she explains the aim of the project and how you can help to make it a success. 

    In the UK 405,000 older people (65+) currently live in care homes. Older people living in care homes have complex health needs and most residents have multiple long-term conditions, significant disability and frailty which affect both their physical and mental health. Dementia affects the majority of residents in care homes to some degree and depression is common. Integrated provision is required to meet the needs of care home residents who require co-ordinated input from generalists and specialists in multiple disciplines, and partnerships are essential to integration.  Continue reading

    Autumn Speakers Series: Benchmarking Practice in UK Long-term care, can we make it work?

    Adam Gordon is Clinical Associate Professor in Medicine of Older People at the University of Nottingham and a Consultant Geriatrician at Derby Teaching Hospitals NHS Foundation Trust. He is a specialist advisor to the East Midlands Academic Health Sciences Network Patient Safety Collaborative on Care Homes and will be speaking at the upcoming BGS Autumn Meeting in London. He tweets at @adamgordon1978

    Contrary to what might be gleaned from the lay media, the quality of care received by residents in care homes – whether from care home or National Health Service staff – is frequently exceptional.  Care home residents are amongst the most complex recipients of care within the health and social care system and so they can stretch even the most capable and dedicated of staff. It is therefore, perhaps, unsurprising that things do not always go to plan – even in the best of homes. There are also, undoubtedly, examples of care homes where things go wrong more frequently – where shortcomings in care are not so much sporadic, as systematic. This is unacceptable. Continue reading

    Unchain me: how our approach to safety leads to harm

    Professor Joseph Ibrahim is Head, Health Law and Ageing Research Unit at Monash University’s Department of Forensic Medicine and the Clinical Director of Geriatric, Rehabilitation and Palliative Care Medicine, at a large regional health service in Australia. Joseph has a keen interest in promoting better care for older people and edits the Communiqués printed educational material designed for health professionals to learn from cases investigated by the Coroners Court. Learn more about Joseph on his personal website.

    Joseph and the team recently completed a landmark Australian study published in Age and Ageing, examining deaths due to physical restraint of people living in nursing homes. The study found that five deaths were recorded in nursing home residents due to physical restraint over the 13-year period. The median age of the residents who died was 83 years; all residents had impaired mobility and had restraints applied for falls prevention; four had diagnosed dementia. The mechanism of harm and cause of death were ascertained by a forensic pathologist following autopsy and in all cases, were formulated as ‘neck compression and entrapment by the restraints’. Continue reading