March issue of Age and Ageing journal out now

The March 2014 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:

  • Sensor technology and falls
  • Postgraduate training in dementia
  • Gender, frailty and life expectancy
  • Secular changes in alcohol consumption
  • Music-based exercise and cognition

The Editor’s Overview can be read here.

This issue’s free access papers are:

 

More Care Less Pathway: End of life care after Neuberger

Dr. Martin Vernon is a Consultant Geriatrician in South Manchester and is the BGS End of Life Care Lead.LCP

Few can have escaped the media driven political debate that erupted in 2012 over the care of dying people in hospital and at home but you may be wondering what has happened since then.  In July 2013, the Independent Review of the Liverpool Care Pathway published the report More Care, Less Pathway. In response to its recommendation for a system-wide strategic approach, the Leadership Alliance for the Care of Dying People (LACDP) was established to provide a focus for improving care of dying people and their families.  You can learn more about the group here.

A Clinical Advisory Group (CAG) was established in September 2013 to consider Review recommendations specific to clinical practice and how these should influence practice. Dr Bee Wee, National Clinical Director for End of Life Care, chairs the group.  The British Geriatrics Society is represented by me and the group includes representatives from NHS England, Royal College of Physicians, palliative care professionals, hospice and care home organisations, the Care Quality Commission, and a layperson. Continue reading

The Liverpool Care Pathway has been made a scapegoat

“It is as illogical to discredit the LCP because of errant clinicians as it is to ban the Highway Code because of bad drivers.”

Claud Regnard, FRCP, a palliative care consultant, has called the demise of the Liverpool Care Pathway a “tragedy” in his paper published in Age and Ageing today.

After a series of media stories about the palliative care system causing malnutrition, dehydration, and premature death in patients across a wide age-range, the Liverpool Care Pathway (LCP) was subject to review by a panel under Baroness Neuberger. The panel delivered their findings on 15 July 2013. They said that the LCP needed to abandon its name, as well as the use of the word “pathway”, and that the LCP should be replaced within 12 months by an “end of life care plan”. Continue reading

To Feed or Not to Feed? This is only half the question

Dr Eleni Tsiompanou is a specialist in nutritional medicine at the Health-Being Institute. She blogs at www.blog.healthbeing.co.uk and Tweets at @DrEleni   Feeding

For some time I have been intrigued by patients who, thought to be dying, were put on the Liverpool Care Pathway (LCP) but instead of dying improved. Such cases of unexpected recovery, reported in the Daily Mail, were of patients on the LCP who had had their treatment, feeding and hydration withdrawn. In two recent articles, in Clinical Medicine and BMJ online, I argue that there is more to these stories than meets the eye. Continue reading

Dying isn’t Working

Following Kate Granger’s blog entry on her personal response to the withdrawal of the Liverpool Care Pathway, we present a blog from Jason Suckley, director of Policy and Campaigns at Sue Ryder, explains what healthcare professionals could do to improve end of life careTrees-nurse-man-wheelchair

In a civilised society and 65 years since the establishment of the NHS, it’s totally unacceptable that individuals and their families remain unsupported at the one of the most life-changing and emotionally challenging times.  Your diagnosis, where you live, or who your doctor is shouldn’t pre-determine whether or not you have a good death – we want to change that.

To work towards addressing the problem, in June, we launched our campaign, “Dying isn’t Working”.  The campaign is based on our own experience as a service provider of end of life care and evidence from two reports we’ve produced with think-tank Demos – Ways and Means (published on 19 June), looking at barriers to accessing end of life care, and A time and a place (published on 9 July), exploring what people want at end of life.  Insights from the reports highlight a number of ways in which healthcare professionals can improve end of life care for all. Continue reading

What is the future of care for the dying?

Kate Granger is an Elderly Medicine Registrar at Pinderfields Hospital in Yorkshire. She tweets at @GrangerKate and blogs at drkategranger.wordpress.com shutterstock_137790233

 

As a vocal advocate of the Liverpool Care Pathway I have experienced a wide range of emotions since the publication of the Independent Review regarding its use, ‘More Care, Less Pathway’.

Initially I was shocked something which had become a routine part of my post registration working life was going to be scrapped. I cannot recall such a prominent change in practice since I qualified. Personally I always found the LCP a very useful framework to employ when caring for dying patients.  As the shock subsided I will admit to some negative emotions; I was upset and angry but mostly disappointed; disappointed that our efforts to dispel the media misrepresentation and scaremongering had been in vain. A feeling of indifference followed. This is a rare feeling for me to experience when it comes to anything Palliative Care related; I am usually so passionate. Continue reading