Falls are common in older people and are the direct cause of many osteoporotic fractures. There are limited treatments available to help frail older people who are at risk of falls. A study funded by the National Osteoporosis Society and the British Geriatrics Society on the potential benefits of whole body vibration for frail older people has now been published in Age and Ageing.
The collaborative work between the University of Loughborough and Nottingham University Hospitals NHS Trust showed that older people attending a falls prevention programme are able to tolerate whole body vibration.
Patients were recruited at The Nottingham University Hospitals Rehabilitation Unit and all of them took part in the NICE recommended falls prevention programme, which includes exercise. They were split at random into three groups. One group used a vibration platform that moved vertically up and down; one used a vibration platform with a “see-saw” action and one group stood upon a stationary platform whilst a buzzing noise was played so that they thought they were receiving vibration (sham vibration). The vibration training involved visiting the unit three times per week over 12 weeks, and standing on the plate during several short bouts of vibration, for a maximum of 6 minutes in total. Continue reading →
Laura Izzard is an Specialty Trainee in Geriatric Medicine at Kings College Hospital, London
PANICOA – the Prevention of Abuse and Neglect in the Institutional Care of Older Adults – is a joint research initiative between Comic Relief and the Department of Health.
Published in December 2013, the PANICOA report ‘Respect and Protect’ draws together the findings of eleven individual research studies commissioned to examine the complex issue of mistreatment of older people in hospitals and care homes. It outlines three vantage points i.e. “narratives” reflecting the perspectives of residents and patients, care staff and care organisations. Themes emerging from the PANICOA Narratives were used by the authors to produce a number of recommendations intended to reinforce and/or improve current practice.
I never considered specializing in geriatric nursing before my academic career at New York University mainly because I have had limited interactions with the elderly. My maternal grandparents died while trying to escape the Vietnam War and my paternal grandparents lived out in the Midwest so I rarely saw them. It wasn’t until last summer that I was able to connect to geriatrics on a more personal level.
At the tail end of summer 2013, I volunteered with the medical relief organization, Floating Doctors, which provides healthcare and medical treatment to isolated coastal communities in Panama. They also worked locally with a live-in geriatric facility, the asilo, by providing regular visits to conduct check-ups and physical assessments, administer medications as well as offer companionship to the residents. For the most part, the residents were in good health and mentally present. However, open sores, scabies, dementia, and debilitation were common afflictions.
The need for better integrated working between health and social care and acute and community services has been recognised for many years in policy and practice. However, despite this emphasis, many older people and their families continue to experience services that do not communicate effectively, are far from seamless, and require considerable persistence to successfully navigate. The increasing challenge of responding to our changing demography with limited resources means that it is more important than ever that we avoid wasteful duplication or gaps that result in older people being unnecessarily admitted to residential care or hospital. Continue reading →
Matteo Cesari, MD, PhD is Chargé de Mission at the Gérontopôle of the Centre Hospitalier Universitaire de Toulouse, researcher at the INSERM UMR1027, and Professor at the Université de Toulouse III Paul Sabatier (Toulouse, France). He is Editor-in-Chief of the Journal of Frailty & Aging. He Tweets at @macesari
Our societies are ageing. The number of older people is steadily growing, threatening the sustainability of public services including healthcare. Age-related chronic and disabling conditions not only adversely influence older people’s quality of life, but also represent a burden for public health expenditures. It is a fact that something has to be done in order to prevent the (often irreversible) loss of physical function that occurs with advancing age. If we are to accomplish such an ambitious task, a major revision is needed in our approach to older people and, consequently, in the concept of geriatric medicine. Continue reading →
Prof John Young is a Consultant Geriatrician in Bradford, UK and National Clinical Director for Integration and Frail Elderly at NHS England. Here he reflects on the 2013 National Audit of Intermediate Care. The full audit report can be found here.
I have been closely involved with the National Audit of Intermediate Care since its inception in 2008. The journey has been challenging but highly rewarding. The audit now covers about half the NHS – remarkable when you consider the commitment required by local staff to collect and submit the data.
The audit is important because it describes services that are otherwise relatively hidden from view in our conventional perception of health and social care. Yet intermediate care, or “care closer to home,” has been quietly developing during the last ten years or so. The focus has always been that of older people with co-morbidities/frailty – just the group that is now so much in the forefront of health and social care thinking. And intermediate care services have always been a platform to develop new ways of working – particularly multi-agency working – and so it is highly relevant to our current interest in service integration. Continue reading →
Today the BGS publishes a two page guide for health service commissioners and planners which sets out what local services should be in place to meet the health needs of older care home residents.
Nearly 400,000 older people live in care homes in the UK. Their health and social care needs are complex. All have some disability, many have dementia, and collectively they have high rates of both necessary and avoidable hospital admissions. Standard health care provision meets their needs poorly, but well-tailored services can make a significant difference. Continue reading →
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. Continue reading →
Social media is the term used for online platforms which enable people to consume information as well as produce their own content – from 140 character updates on Twitter through to sharing photos on Instagram, and much more besides. Whether we use social networks or not, they are increasingly incorporated into day to day life, and not just for younger people: Age UK report that the number of 55-64 year old internet users creating a social network profile rose by almost half last year, and many use social networking to keep in touch with family and friends and to reduce social isolation. Continue reading →
Nearly 400,000 older people live in care homes in the UK, and more than half of residents are aged over 85. Their health and social care needs are complex. All have some disability, many have dementia, and collectively they have high rates of both necessary and avoidable hospital admissions. Despite this, the UK has no easily accessible source of national data on the NHS care received by residents, and collectively, we know relatively little about their health and well-being. This absence of routine data sources prompted an examination of information provided by other studies. Continue reading →