‘Proud Carer’

Karolina Gerlich is a proud carer and a NACAS Director. She has worked as a carer for the past 7 years, and brings experience of business management and providing training. She is studying for a degree is Psychology with the Open University and for a BTEC HND in Health and Social Care. Follow @NacasUK

The National Association of Care & Support Workers (NACAS) was founded in 2016. The association is directed by care workers and aims to improve health and social care through our members. We are working hard to improve training standards and ensure that care profession gets the respect and recognition it deserves.

There are a variety of titles given to those who provide care professionally; our members are home-carers, care-home carers, personal assistants, support workers, healthcare assistants, as well as managerial staff. Regardless of the job title, we all provide care to people, and often spend a great deal of time with them.

Take the high road or the low road…but don’t miss the BGS in Glasgow this November!

Dr Eileen Burns has been a geriatrician in Leeds since 1992 and is President-Elect of the BGS. She is currently Clinical Lead for integration in Leeds and Chairman of the BGS Community Geriatrics Special Interest Group. She tweets @EileenBurns13

The Autumn Meeting of the BGS in Glasgow this November looks to be a great event with a broad range of topics and sessions.

But the day that excites me the most is Wednesday November 23rd.

Many of us have been approached by commissioners of services to “move into the community” in some way (in whichever part of the UK we are based). Others have seen the need to look at alternatives to acute hospital care for older patients with less severe illnesses, and it’s been clinicians rather than commissioners or managers who have been the spark for new developments.

Get healthcare providers to improve care together, that’s the challenge

Noor Heim is an assistant professor who currently works for the University Medical Center in Utrecht. In this blog, she discusses her recent Age & Ageing paper on research she has done in the Leiden University Medical Center.

Integration of treatment and care from multiple disciplines is particularly critical in care for older people. Most older people admitted to a hospital suffer from more than just one (chronic) condition. As a consequence, coherent care for older patients involves more than just one discipline. Furthermore, the fact that patients are discharged from hospital quicker and sicker, with higher demands of care, increases the need for integration of (transitional) care between settings. Given the number of older adults who permanently lose the ability to perform one or more activities of daily living during and after a hospital admission, one has to conclude things need to be improved. However, it has proven challenging to accomplish improvements and maybe even harder to study (and to quantify) the benefits of the efforts taken.

Integrated care for frail older people: does it work?

Emiel Hoogendijk is postdoctoral researcher at the VU University Medical Center in Amsterdam, the Netherlands, where he works for the Longitudinal Aging Study Amsterdam. He discusses his Age & Ageing paper ‘How effective is integrated care for community-dwelling frail older people? The case of the Netherlands’

How can we optimise quality of care for frail older people in the community? That is an important question, which is not easy to answer. Integrated care programs are often seen as the solution. These programs are characterised by a multidisciplinary approach, with personalised care based on comprehensive geriatric assessments. In many countries, these programs are implemented in primary care. However, the beneficial effects of these programs are not so clear. It is important to report on both successful and less successful initiatives in the field. By comparing effective and non-effective interventions we may identify elements which can make a difference for frail older people.

“What good integrated care looks like”: the CQC Thematic Review

 

Dr Elizabeth Kendrick is a GPwSI for older people and National Professional Advisor for older people for the Care Quality Commission. For further information please contact elizabeth.kendrick@cqc.org.uk

CQC has begun a review that explores how health and social care services currently work together to deliver care for older people that is integrated.

National Audit of Intermediate Care 2015

Dr. Duncan R Forsyth is a Consultant Geriatrician at Cambridge University Hospitals Foundation Trust. Here he tells us about the report of the fourth National Audit of Intermediate Care (NAIC) which was released 11 November 2015.

The NAIC provides a unique assessment of progress in community services aimed at maximising independence and reducing use of hospitals and care homes. Three hundred and forty services contributed to the audit with over 12,000 responses from the service user audit and Patient Reported Experience Measure (PREM). Four service categories are examined: crisis response, home based intermediate care, bed based intermediate care and reablement services.

Care home residents deserve the best care. The best care is integrated.

Dr Adam Gordon is Clinical Associate Professor in Medicine of Older People at the University of Nottingham.  He works as a community geriatrician and conducts research into models of care delivery in care homes. From 2013 to 2015, he was Honorary Secretary of the British Geriatrics Society.

Care home residents have complex care needs. Between 75 and 80% of residents have memory problems, 57% are affected by urinary incontinence, 42% have faecal incontinence and some 61% require assistance with mobility. The average number of medications per resident is 8 and the average number of medical diagnoses is 6.

Much of the health and social care provided in care homes is excellent, but it is not surprising that things break down from time to time given the complexity of the care problems seen. When things do break down, it is often the failing of multiple parts of the system at the same time. Recent scandals around hydration in care homes have seen residents cut down on their fluid intake because they were worried about accessing enough of the right continence supplies, whilst both health and social care staff failed to recognise the problem until the resident’s health had deteriorated to a critical state.

January issue of Age and Ageing journal out now

The January 2015 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. Hot topics this issue include:

• Deprivation of liberty safeguards
• Biomarkers for dementia
• Clinical features of delirium
• Physical therapy for knee osteoarthritis
• Integrated care for older people

The Editor’s View can be read here.

This issue’s free access papers are:

• The contribution of geriatric medicine to integrated care for older people

• Much more medicine for the oldest old: trends in UK electronic clinical records

• Alcohol consumption and physical functioning among middle-aged and older adults in Central and Eastern Europe: Results from the HAPIEE study

• Economic evaluation of the differential benefits of home visits with telephone calls and telephone calls only in transitional discharge support

Integrated care – how to make a mountain out of a molehill?

David Stott is Professor of Geriatric Medicine at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow and is Editor in Chief for Age and Ageing journal.

Integrated health and social care has been promoted as a key solution to the challenge of providing high quality care with a restricted budget. Philp summarises current thinking in a New Horizons article recently published in Age and Ageing.

The aim of providing a fully integrated system including coordination of organisation of health and social services sounds sensible. After all who would argue for disintegrated and disorganised care?

However there are problems and challenges, not with the concept of integration, but in the organisation and systems that are being ‘pushed’ to effect integration.

Avoiding Serial Projectitis – Making Health and Care Systems fit for an Ageing Population

David Oliver is a Consultant Geriatrician in Berkshire and a visiting Professor in Medicine of Older People at City University, London. He is President Elect of the British Geriatrics Society. He writes on the King’s Fund blog about their paper, launched today.

By 2030, one in 5 people in England will be over 65 and at that age, men will on average live till 88 and women till 91. This population ageing shouldn’t constantly be catastrophised with language like “burden” “timebomb” or “tsunami”. In fact, it represents a victory for improved societal conditions and for modern healthcare – preventative and curative. Indeed, well into older age, most people report high levels of happiness, health and wellbeing and even over 80, only half say they live with life limiting long-term conditions.

However, despite the “upside” of population ageing, we need to be realistic about its inevitable implications for health and care services.