Autumn Speakers Series: Ageing and economic growth – not all doom and gloom?

Baroness Sally Greengross is Chief Executive of the International Longevity Centre – UK and has been a crossbench (independent) member of the House of Lords since 2000. She Co-Chairs four All-Party Parliamentary Groups: Dementia, Corporate Social Responsibility, Continence Care and Ageing and Older People. She was awarded a Special Lifetime Achievement Award at the BGS 70^th Anniversary Reception on 6 March 2017.  She will be speaking at the upcoming BGS Autumn Meeting in London.

What are the economic and societal effects of a global ageing society and the increasing need for a healthy older population who will be employed into their 70s? 

Firstly it is worth saying that ageing and economic growth – is not all doom and gloom? Population ageing is a global phenomenon. The rate of growth in older people (people aged over 65) is expected to far outpace the rise of the working age population (people age 15-64). The old age population will grow by more than 300% over the course of this century by comparison with the working age population which will grow by less than 50%.

Geographic variation of inpatient care costs at the end of life

Claudia Geue is a health economist at the University of Glasgow with a special interest in the pattern of healthcare utilisation and associated expenditure at the end of life. In this blog she discusses her recent Age & Ageing paper on healthcare costs.

We know that the last months of life are characterised by high healthcare costs, in particular when we look at the costs for hospital admissions. What is less clear though is the question whether there are any geographic variations in costs at the end of life.

Identifying health and social care costs for older people

Rachel Elliott and Matthew Franklin are reporting on behalf of the Medical Crises in Older People (MCOP) research team at the University of Nottingham.

As part of a programme developing and evaluating care in older people, our team wanted to know the distribution of health and social care costs of older adults discharged from Acute Medical Units (AMU) in England across six care services (primary care, hospitals, intermediate care, mental healthcare, social care, and the ambulance service). This is the first study to do this in England.

You can save lives and money

Paul Harriman has recently published his paper ‘Timely care for frail older people referred to hospital improves efficiency and improves mortality without the need for extra resources‘ in Age and Ageing journal. Today he describes his findings on the OUP blog:

There is a truism in the world that quality costs, financially. There is a grain of truth in this statement especially if you think in a linear way. In healthcare this has become embedded thinking and any request for increasing quality is met with a counter-request for more money. In a cash-strapped system the lack of available money then results in behaviour that limits improvement. However, as an ex-colleague once said “we have plenty of money, we just choose to spend it in the wrong places”. This implies that if we were to un-spend it in the wrong place we would have plenty of spare cash.

7-Day Working: Enjoy these weekends while you can…

Amit Arora is a consultant physician in care of older people and Chair of the England Council of the BGS.

The Francis report, Bruce Keogh’s mortality review, the winter beds crisis, A/E crisis and Future Hospitals commission report from the Royal College of Physicians and some statements from the Hon Health Secretary have a common theme- Care of Older people. It comes as no surprise that finally the realization seems to have come that care of older people can be improved and though expensive, it is worthwhile.

‘She’s been up at casualty with another fall’

Consultant geriatrician at the Queen Elizabeth Hospital in Birmingham and co-chair of the BGS Falls and Bone Health Section, Dr Jonathan Treml, advises on how to tackle this common tricky presentation in a ten minute consultation.  This article first appeared online in Pulse, a website aimed at GPs and other primary care professionals and which tweets @pulsetoday.

Falls are a common and potentially serious problem affecting around a third of older people each year. Often disregarded as an inevitable part of the ageing process by both patients and doctors, falls can be the first sign of frailty, disability and dependence.

Most falls in older people are the result of multiple risk factors, often including impaired gait, balance and mobility. Falls can be the presenting complaint of underlying pathology – including postural hypotension or syncope, vestibular or visual impairment, Parkinson’s or other neurological disease.

A doctor’s main roles in falls prevention are identifying and treating underlying problems, ensuring medication is reviewed for fall risk and bone health, and appropriate referral to falls prevention exercise programmes.

Japanese lessons on dementia care

Dr Mayumi Hayashi is a Leverhulme early career fellow in the Institute of Gerontology at King’s College London. She discusses the Japanese approach towards dementia care and suggests lessons for the UK.

Last year, the British coalition government emphasised the need to improve dementia care, with David Cameron launching his “challenge on dementia“, which identified three major goals: better health and care, fostering “dementia-friendly” communities, and improved research. Initial successes included a substantial increase in primary care trust funding for dementia care, but subsequent cuts in government spending resulted in reduced funding for the condition. Discussions in Whitehall about finding new, yet cost-effective, initiatives have been informed by Japan’s experience. There, politicians and policy makers have focused on educating the public (even the term “dementia” was outlawed) by recruiting and mobilising volunteer dementia “supporters”, and implementing a new national compulsory long-term care insurance system, offering enhanced services for people with dementia.

The social and economic contribution of our elders

A conference report from the BGS Spring Meeting in Belfast, by Liz Gill.

Another look at the future came from Claire Keating, commissioner for older people in Northern Ireland. “Shed loads of people are having increased longevity and that is a challenge but no-one becomes 80 overnight so it’s a case of planning. And current projections are not set in stone. For instance, we need to treat older people who have bowel cancer now but we also need to get their grandchildren to eat more vegetables so that there aren’t unacceptable levels when they get to that age.

“We get obsessed with money and the pessimistic outlook gets more attention. Yet the latest research shows that when you add up all economic and social contributions and all the taxes and voluntary work, older people make a net contribution to society of £40bn.

European Courts and Old People

Graham Mulley is emeritus professor of elderly care, University of Leeds.

image Gwenaël Piaser

The current issue of Age and Ageing features an original paper on Older Europeans and the European Court of Justice by Israel Doron.  Why should busy geriatricians be interested in legal activities in Europe?

The short answer is that these courts have the potential for championing old people’s human and legal rights.  These courts often judge in favour of elders, yet the number of cases referred is small and is not increasing – despite the greater numbers of elderly citizens.

Francis Report – A Nursing Perspective

Jane Buswell is Chair of the BGS Specialist Nurse and Senior Practitioners Group

On reading the Francis report one might be misled into thinking that the report points to nurses as having sole responsibility for delivering compassionate care and that the only professionals delivering care within the NHS are nurses and doctors. It is unfortunate that the significant role of our Allied Health Professional colleagues within the multi-disciplinary team, and their potential for leadership, has not been recognised in this wide ranging and seminal report.

It would be wrong to look at the individual professional recommendations in isolation. Only 33 of the 209 recommendations are specific to nursing. However, many of these are addressing the same issues of leadership, training, regulation, professional accountability and the roles of our professional bodies, all of which apply equally to doctors, and all other professionals within the NHS.