The Paper Boat

Patricia Cantley works as a consultant physician in the Midlothian Hospital at Home Team, offering an alternative to hospital admission for frail and older patients. She also works in the Royal Infirmary in Edinburgh and in the Community Hospital in Midlothian. She tweets under her married name of Elliott as @Trisha_the_doc

I’ve been reading a lot recently about the word Frailty and its importance within Medicine for Older People. We see a lot of frail people and as geriatricians they are our core business both inside and outside the hospital.

Healthcare professionals have debated over the last few years how to define Frailty, and even how we might begin to measure it. It is no longer adequate simply to shrug and say “we know it when we see it”. Continue reading

Practical palliative care after stroke

Dr Ruth England is a Consultant in Palliative Medicine at Royal Derby Hospital. She tweets @DrRuthEngland. She will be speaking at the upcoming BGS event Living and Dying Well with Frailty on 6 March in London. Please note this event has now SOLD OUT.

Palliative care is an active, holistic approach to those facing life-threatening illness. Good palliative care allows us ‘to live as well as possible for as long as possible’; and includes support for those approaching the end of their life.

In the UK, someone suffers a stroke every 5 minutes. Although there has been a decline in stroke mortality, it remains a leading cause of death in those aged over 65.  There a high risk of dying immediately after an event, and 40% of those affected by stroke die within a year. Long term survivors are likely to be burdened with ongoing physical, psychological and social issues. Continue reading

Designing safer systems of care delivery for older patients

A new study published in Age & Ageing, the scientific journal of the British Geriatrics Society, identified incidents when poor communication between secondary and primary care and failures within primary care led to patient harm and highlights how improved communications systems could help protect older patients from harm. Timely electronic transfer of information with standardised formats could reduce medication and clinical decision-making incidents. Electronic alerts and expanded use of bar-coding are examples of systems which could tackle drug administration incidents.

Older adults are frequent users of primary healthcare services and account for half of all 340 million general practice consultations in the United Kingdom each year.  The study was conducted by researchers at Cardiff University School of Medicine and examined 1,591 patient safety reports relating to patients aged over 65 in England and Wales over an eight year period. Continue reading

The British Geriatrics Society welcomes the NICE Delirium Quality Standards

Duncan Forsyth is Consultant Geriatrician in Cambridge and was a specialist adviser to the Quality Standards Development Group.shutterstock_20378521

On July 24th 2014, NICE published its Delirium Quality Standards to assist health and social care drive-up the quality of delirium management in hospital and care home settings. The standards cover: assessment; prevention; use of antipsychotic medication; communicating the diagnosis; information and support to those who have delirium and their carers. Delirium is probably the commonest complication of hospitalisation in older people and has a high prevalence in those in long-term care. Continue reading