Improving Well-being: Step 1-Physical Activity

Public Health England have recently published new evidence and online guidance to help healthcare professionals embed physical activity into daily life.

Called Physical Activity: Applying All Our Health  the resource aims to help health professionals prevent ill health and promote well-being as part of their everyday practice.

The information provided aims to help front-line health and care staff use their trusted relationships with patients, families and communities to promote the benefits of physical activity. It also recommends important actions that managers and staff holding strategic roles can take.

It includes examples to help healthcare professionals understand specific activities or interventions which can:

  • prevent physical inactivity
  • protect through physical activity
  • promote healthier more active lifestyles

Also in the post is a link to an eLearning version of the information provided by eLearning for Healthcare (Worth signing up to because of the number of resources you can access).

The NHS Scotland equivalent page can be found at http://www.healthscotland.scot/health-topics/physical-activity/physical-activity-overview

but its perhaps not as interesting.

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It’s Allied Health Professions Day! Let’s Celebrate Their Work #AHPsDay #AHPsDayScot #ProudToBeAHP

There are fourteen different healthcare roles recognised as Allied Health Professionals (AHPs); each one of them carrying out an important role in the lives of the people that they are caring for. If you want to find out more about the 14 professions see the following page at Health Careers

So this week rather than focusing on a paper or a topic that’s in the news let’s  just highlight what the 14 professions do and how they make a difference.

As part of the day a Google site has been created and on the site is a whole lot of material of use to help people understand AHP roles and the contributions they make. The site can be found HERE 

It includes video, NHS Recruitment information, some materials from the AHP’s  professional bodies and some teaching materials.

The Nursing Midwifery and Allied Professions group at NHS Education for Scotland have also released a series of videos from their AHP staff on the programmes that they are currently involved in which you can view at https://twitter.com/NESnmahp

This week the Alzheimers Scotland Blog “Lets Talk About Dementia” are also running a serieds of Blogs on AHP contributions to Dementia care which you can access at https://letstalkaboutdementia.wordpress.com/

So lots to celebrate and be proud of if you are an AHP. AND if you are an AHP reading this Blog have a great day and keep up the good work!

Identifying and Managing Frailty in Care Homes

People in care homes are the most likely group of people in society to experience Frailty. However the Registered Nurses working in care homes are the least likely to receive any education or training specifically targeting frailty issues. They are though, a crucial component of care delivery to frail older people and are in an excellent position to support frail people who have complex care needs and comorbidities and are at risk of unplanned admissions to secondary care (because that is what they are doing every day).

Identification of frailty is important because aspects of the factors contributing to it may be reversible.

In July an article by Lynn Craig, a Senior Lecturer, Northumbria University and Clinical Development Managerwith North Tyneside Clinical Commissioning Group, published an article

Craig, L., 2019. The role of the registered nurse in supporting frailty in care homes. British Journal of Nursing28(13), pp.833-837.

In the article she explores frailty and the role of the nurse in assessing for frailty particularly in relation to 4 aspects, nutrition status, polypharmacy, exercise and cognitive function; areas which she suggests nurses could target in order to better support reducing the negative health outcomes of frailty.

Usually I’d provide a link to let you see the article for yourself but this time you will need to look for it and download it yourself.

If this has sparked an interest in frailty you should probably look at

Janet’s story: Frailty. which is an NHS RightCare resource that compares a suboptimal care pathway with an ideal pathway. which you will find at https://www.england.nhs.uk/rightcare/products/ltc/ 

Dementia Stigma is an International Concern

Its the end of September so as always at the end of World Alzheimers Month,  Alzheimer’s Disease International publish a new World Alzheimer’s Report.

The report reveals the results of the largest attitudes to dementia survey ever undertaken, with almost 70,000 people across 155 countries and territories completing the survey. It spans four demographic groups: people living with dementia, carers, healthcare practitioners and the general public. Analysis was carried out by the London School of Economics and Political Science (LSE).

Some of the key findings of the report include:

  • Almost 80% of the general public are concerned about developing dementia at some point and 1 in 4 people think that there is nothing we can do to prevent dementia
  • 35% of carers across the world said that they have hidden the diagnosis of dementia of a family member
  • Over 50% of carers globally say their health has suffered as a result of their caring responsibilities even whilst expressing positive sentiments about their role.

For me the two findings that cause the most concerns were that almost 62% of healthcare providers worldwide think that dementia is part of normal ageing.

Perhaps worse 40% of the general public think doctors and nurses ignore people with dementia and and 33% of people thought that if they had dementia, they would not be listened to by health professionals.

Now those figures are bad, but unbelievably over 50% of healthcare practitioners agreed that their own colleagues ignore people living with dementia.

The report reveals that stigma around dementia still prevents people around the world from seeking the information, advice, support and medical help that could dramatically improve their length and quality of life for what is globally one of the fastest growing causes of death.

“Stigma is the single biggest barrier limiting people around the world from dramatically improving how they live with dementia,” says ADI’s Chief Executive Paola Barbarino.

“The consequences of stigma are therefore incredibly important to understand. At the individual level, stigma can undermine life goals and reduce participation in meaningful life activities as well as lower levels of well-being and quality of life. At the societal level, structural stigma and discrimination can influence levels of funding allocated to care and support.

“…currently, there is very little information about how stigma manifests in relation to people with dementia and how this may vary around the world. This detailed survey and report now give us a baseline of information for dementia-related stigma at a global, regional and national level. We’re hopeful these findings can kick start positive reform and change globally.”

If you want to read more about the report and download a copy go to https://www.alz.co.uk/research/world-report-2019

Older People Are Concerned About Climate Change Too!

Thousands of young people are taking part in school strikes across Scotland and around the world today to demand urgent action on climate change. The protests are the latest in a series of strikes started a year ago by 16-year-old Swedish schoolgirl Greta Thunberg, which have have now spread across 150 countries. Today’s action is the largest so far. Events are planned in all of many of the UK’s major cities, many towns and some islands including Iona and Skye.

What is often forgotten though is that older people are disproportionately affected by climate change.

The relationship is very clear. In cold weather extremes and in heatwaves and in any other kind of extreme weather or natural disaster, its older people that experience the most morbidity and mortality. Essentially older people have fewer resources to deal with disaster and they can’t get out of harm’s way fast enough.

For an example nearly half of the individuals who died during Hurricane Katrina in 2005 were 75 or older. When Hurricane Sandy hit New York in 2012, almost half of those who died were over 65.

A New York Times article, reproduced recently in the Independent called them the “forgotten generation”. Not just because they were forgotten in disasters but also because they were an untapped resource. Baby boomers, because of their huge numbers and voting power have great potential to make a difference to this protest movement.

Age International and Help Age International have been very aware of the problems of older people during disasters and even a quick look at Age Internationals Emergency Aid page (CLICK HERE) and this article by Help Age International (CLICK HERE) will give you a clearer idea of just how disproportionately they are effected.

Rather ironically the best resource that I could find explaining the impact of climate change on older people’s health is from the United States Environmental Protection Agency. Called ‘Climate Change and the Health of Older  Adults’ you can download it here!  

Reducing Type 2 Diabetes Through Weight Loss Alone

This is a bit of a departure for me as I have picked something that’s not necessarily relevant to older people but more relevant I think to the people who might read this Blog. Thanks to UNIVADIS for bringing this to my attention.

We often hear that Type 2 diabetes (T2D) can be avoided by losing weight and altering your diet, See Understand Your Risk but what if you have Type 2 diabetes already!

How much weight reduction is required to achieve T2D remission?

A recent paper published by a team from the University of Cambridge, School of Clinical Medicine, conducted a study that looked at this question and found that achieving weight loss of ≥10% within a few years of getting a T2D diagnosis is strongly associated with remission at 5 years. About a third of people who managed this achieved remission.

Why this matters

  • About 422 million people worldwide have diabetes, a number likely to more than double in the next 20 years. Type 2 accounts for around 90% of all diabetes worldwide. Reports of Type 2 diabetes in children have increased globally (WHO 2019)
  • Previous studies have shown that T2D remission is possible with intensive caloric restriction/lifestyle intervention, but few have addressed less-intensive interventions.

Study design

  • Prospective cohort study of 730 people aged 40-69 years newly diagnosed with T2D

Key results

  • Diabetes remission (HbA1c <48 mmol/mol; 6.5%), without any diabetes medication or bariatric surgery, was achieved in 257 participants (30%).
  • Those achieving remission were more often male, smokers, and with full-time education beyond age 16 years.
  • Compared with no weight change and after adjustments, people who lost ≥10% of body weight in first year after diagnosis were significantly more likely to achieve T2D remission at 5 years (risk ratio, 1.77; P<.01).
  • Remission likelihood was non-significantly increased for 5%-10% weight loss (risk ratio, 1.24; P=.17).
  • In subsequent 1-5 years, ≥10% weight loss was also associated with remission (risk ratio, 2.43; P<.01).
  • No consistent patterns of associations between unit changes in health behaviours (energy intake, physical activity, etc.) and T2D remission.
  • The study was conducted within a primarily white population.
  • Funding was published by Wellcome Trust; Medical Research Council and the UK National Institute for Health Research.

You can access the whole paper via

Dambha-Miller H, Day AJ, Strelitz J, Irving G, Griffin SJ. (2019) Behaviour change, weight loss and remission of Type 2 diabetes: a community-based prospective cohort study. Diabetic Medicine. 2019 Sep 3 [Epub ahead of print] at  doi: 10.1111/dme.14122. PMID: 31479535

Are You Ready for 64? What about 86 and Maybe More?

I quite liked this as an introduction to this weeks topic. Today’s fifty-year-olds are likely to have an astounding 36 or more years to live. So if you’re approaching later life, you need to think very differently about what those extra years will hold.

So two things that you will have to consider in this weeks. A plan for your future at work and help in achieving the goal of a fabulous later life. Interesting you can find guides to both on the Centre for Ageing Better’s website this week.

Firstly they have published a new report on Employers, suggesting that they should do more for workers in their 40s and 50s to help them plan for the future.To read more about their findings and to download the full report follow THIS LINK 

The Centre for Ageing Better says

…providing mid-life support is an essential part of how employers can respond to the changing nature of the workforce. Workers over the age of 50 now make up a third of all UK workers, but there are more older people leaving work than younger people coming in to replace them. Supporting staff to plan ahead could help employers avoid potential staff and skill shortages, as well as ‘cliff edge retirements’ where people are working one day and stop work entirely the next.

The second item is a new book that the Centre helped to produce called When We’re 64 by Louise Ansari

The book is a friendly, practical guide to preparing for what could be the best years of your life – from the essentials on work and how to fund retirement, to volunteering, where to live and what kind of housing you’ll need The book aims to provide knowledge, tips and pointers to help you think very differently about opportunities that a long life can bring. You can find out more about the book and how to purchase it by CLICKING HERE.