Professor Rowan Harwood is a geriatrician at Nottingham University Hospitals NHS Trust, and the University of Nottingham, with particular interests in delirium, dementia and end of life care, who maintains an active portfolio of research. He tweets @RowanHarwoodHe will be speaking at the upcoming BGS Spring Meeting in Nottingham.
Why diagnose dementia? And why diagnose dementia early? Because we want to do something to make lives better? If so, what?
People living with dementia are vulnerable to a cascade of failing abilities, inactivity, deconditioning and crises from which they may not make a full recovery. Most people living with dementia are, by definition, frail – prone to deterioration and adverse events. The average age of diagnosis is about 85. Ideally early intervention should preserve activity and independence and reduce risk, including risk of the commonest adverse event, falls. Yet the ‘offering’ of health service in response to a dementia diagnosis is painfully thin – cholinesterase inhibitor drugs, cognitive stimulation therapy and a dementia advisor maybe. Continue reading →
Reinhard Guss is a Consultant Clinical Psychologist, Clinical Neuropsychologist; Dementia Workstream Lead, Member of the Faculty of the Psychology of Older People, BPS and Deputy Chair, Memory Services National Accreditation Programme. He will be speaking at the upcoming BGS Spring Meeting in Nottingham.
Clinical Psychologists have been part of Memory Clinics as long as they have been in existence as a part of service provision in the UK, using neuropsychology skills in the diagnostic process and in the development of coping strategies and employing clinical and psychotherapeutic skills in assisting with adjustment to a dementia diagnosis and in the support of families and carers. An overview of the Psychology position on dementia can be found in the recent paper to the British Psychological Society’s Dementia Advisory Group.
Historically, the diagnosis of dementia was often the domain of Neurologists and Psychiatrist, particularly when this affected younger people, while Geriatricians would have encountered dementia in older people, and may or may not have seen a need to diagnose it in socio-historic context where dementia was seen as untreatable and often a part of ageing that was to be expected. Continue reading →
Claire Howard is a Stroke Specialist Research Orthoptist based at Salford Royal Hospital and is part of the VISION research unit at University of Liverpool. She holds an NIHR clinical fellowship and is currently researching the area of adaptation to post stroke visual field loss. Her main field of interest is rehabilitation of visual impairment following stroke. She will be speaking at the upcoming BGS Spring Meeting in Nottingham.
The size of the problem: the point prevalence of visual impairment in stroke survivors has been reported as 72% (Rowe, Hepworth, Hanna, & Howard, 2016). This visual impairment can be the result of a range of different problems either individually or in combination; these problems include visual field loss, eye movement disorders, reduced / blurred vision and visual perception defects. In the post stroke period, a person may be experiencing a visual impairment that is of new onset, or their visual problems may pre-exist the stroke. Continue reading →
Louise Allan is a Geriatrician with a specialist interest in the Neurology and Psychiatry of Old Age. Her research interests include the non-Alzheimer’s dementias and the physical health of people with dementia. She will be speaking at the upcoming BGS Spring Meeting in Nottingham.
Between 47-90% of people with dementia (PWD) fall at least once a year (almost ten times more often than controls). After a fall, PWD are less likely to recover well, more likely to be hospitalised, are hospitalised for longer and are more likely to require increased care. We currently know little about the care received by these patients. There is evidence to suggest that staff may perceive PWD as less capable of rehabilitation and staff in community services providing follow-up care may not have specific training in the care of PWD. Continue reading →
Nathan Davies is a Senior Research Fellow at University College London focusing on care for people with dementia towards the end of life and supporting family carers. In this post he talks about his upcoming talk at theBGS Spring Meeting in Nottingham on his work developing rules of thumb for providing care towards the end of life for someone with dementia.
Can rules of thumb help manage uncertainty and the challenges facing practitioners caring for someone with dementia at the end of life?
We know that caring for someone towards the end of life can be a rewarding and intimate experience with that individual and those close to them. However, unfortunately for practitioners it can also be emotionally tough and challenging. This is particularly the case when caring for someone with dementia towards the end of life. Continue reading →
John Gladman is Professor of the Medicine of Older People, Division of Rehabilitation and Ageing and Honorary Consultant in Health Care of Older People at Nottingham University Hospitals NHS Trust. He will be speaking at the upcoming BGS Spring Meeting in Nottingham.
Is getting old about decline or about personal growth?
At the BGS Spring Meeting in Nottingham, the organisers have, perhaps unwisely, asked me to give a lecture. I presume I was asked in view of the large and active research group in academic geriatrics in Nottingham, Derby and Leicester for which I have become the titular head (I think that’s what they call me). I intend to abuse this honour by ruminating on a few things that puzzle me as I approach my dotage and probably won’t mention our research at all. Continue reading →
Dominick Shaw is an Associate Professor and honorary clinician at the University of Nottingham and Nottingham University NHS Hospital Trust. He leads the commissioned severe asthma service and performs clinical studies in asthma. He will be speaking at the upcoming BGS Spring Meeting in Nottingham.
Asthma still presents a major challenge to society. Although classically regarded as a disease of children and young adults, accumulating evidence suggests that late onset asthma carries a poorer prognosis. Moreover although the death rate from asthma has fallen over the last 10-15 years in people under 75, in those aged over 75 it has doubled. Consequently the overall mortality rate has not changed.
Asthma still causes significant social and financial problems for patients, with recurrent exacerbations needing oral steroids, hospital admissions, time off work and impact on families and carers. There is light at the end of the asthma tunnel however and asthma has advanced a long way from, in the words of a geriatrician colleague*, “one puff of the blue, two of the brown”. Continue reading →
Did you know there are more bacteria living in your mouth than there are people in the world? The mouth is biggest hole in the body – it is highly visible, we eat though it, talk through it and smile with it, but when we need help caring for it, often that help is not there! Yet deteriorating oral health can have severe consequences for the rest of the body…
If you have a problem with your vision a doctor will check your eyes, but if you are not eating is it common practice for a doctor or nurse to check if there are problems with the mouth? Continue reading →
As a hospital dentist it’s always a heart sink moment when you get the referral from the ward that reads, “Mrs X has lost her dentures, please could you replace them”. If only it was that easy…
Mrs X has not only lost her dentures, but also the ability to eat her meals, communicate clearly, smile at her family and potentially, her dignity.
It is normally a similar story. Mrs X had fallen asleep and her dentures weren’t there when she woke up, she had wrapped them in some tissue to keep them clean, safe or left them on her meal tray. One way or another they were accidentally mistaken for rubbish and disposed of. She had been in hospital for days yet no one had asked if she had dentures and therefore she wasn’t provided with a denture pot to keep them clean. Continue reading →
Most of the readers of this blog can look forward to a healthy and long(ish) life. The likely quality of that life is, of course, open to debate and depends on a number of factors. One of these factors is concerned with the accessibility and usability of many of the technologies through which we’ll be able to keep engaged (and, yes, that does include working into our older age). Another factor relates to our use of sometimes specialist technologies that can help us with our ailing bodies or minds. Continue reading →