“Alexa… What does Gran/Grandad want for Christmas this year?”

What about Tablet?

This week saw the release of a New NIHR Themed Review called “Help at Home”.

Help at Home brings together recent National Institute of Health Research (NIHR) and other government funded research which has a focus on the use of technology in the home and designing better environments for older people.

This review features the work of 40 published studies. It also sets about giving care providers questions to ask about how technology can support older people living with complex conditions and what designs could help create an ageing friendly environment.

I am a big fan of making use of technology when it can help people to stay living well and safely at home as they get older. However my caveat is always that it has to be the right technology, tailored to the individual. BUT that alone is not enough, the person its for has to be willing to use it (and capable of learning how to use it), or you quickly find its a waste of money, time and effort.

There has been considerable investment recently in developing and evaluating assistive technologies for older people. However this is a relatively new field and there are still important gaps in what we know.

What is in the review has been selected with help from an expert steering group who focused on research around the use of technology in the home, remote monitoring systems and designing better environments for older people. You can read more at:

Help at Home Review

I am hoping this is arriving in your inbox just in time for Christmas. Christmas isn’t just for children

“Alexa… What does Gran want for Christmas this year?”

Maybe her own smart speaker or tablet!


#CarersRightsDay: We Need to Support an Increase in Carers Allowance Across the UK

Carers Rights day

Today is  

There are 759,000 adults carers in Scotland – 17% of the adult population and an estimated 29,000 young carers in Scotland – 4% of the under 16 population and without them the health and social care system would collapse.  So I am asking you to support Carers UK’s  campaign to increase Carer’s Allowance by at least £8.50, to match the changes being made in Scotland. Carer’s Allowance is the main benefit for carers and you can still get it even if you are working, so long as your earnings are no more than a weekly amount known as ‘the earnings limit’. The government has announced that the earnings limit will be going up to £123 per week from April 2019. While this should be good news for carers in low paid work, many of those on the National Living Wage (NLW) will not benefit. for more details see the post here at the CONTACT website

If you are looking after someone you might want to look at and download this handy guide for anyone caring for family or friends – it outlines your rights as a carer and gives an overview of the practical and financial support available:

Finally, on the same theme, a report from the Social Care Elf on a recently published paper called:

Sense of coherence and mental health of caregivers: a systematic review and meta-analysis

Which is about trying to identify early warning signs of psychological distress in carers.

See also

Inappropriate Prescribing: A Reminder

In 2017 the World Health Organization launched its third global patient safety challenge with the aim of reducing severe avoidable medication-related harm by 50% over a five year period. See Medication Without Harm

Demonstrating success in achieving this may be difficult, but countries such as the UK are in a strong position to meet the spirit of this challenge because we have strong integration of our healthcare systems and electronic health records which we could probably use more effectively.

A very important approach is to identify potentially inappropriate prescribing and correct it where necessary, with the expectation that intervening will avoid serious harm. Yet, around half of older patients are exposed to potentially inappropriate prescribing each year and hospitalisation puts them at an increased risk, a new study conducted in Eire shows.

See: https://www.bmj.com/content/363/bmj.k4524

The authors of this study point out that medicines management services for inpatients in Ireland are broadly similar to those in the UK.

Their finding is worrying because inpatient admissions can provide the opportunity for specialist teams to review and optimise management of older patients’ chronic conditions, including their drugs. So, although hospital admissions have the potential to improve management of drugs, this study suggests that the possible benefit of more appropriate prescribing after discharge to primary care is not being realised.

Something somewhere seems to be going wrong. The authors suggest that improving coordination of transitional care (hospital to home and vice versa) particularly for older patients with complex care needs has the potential to reduce mortality, hospital readmissions, and the number of readmissions. Time to look again I think at the UK’s electronic drug management systems and the organisation of discharges from hospitals.

Why is it so difficult to get an electronic summary care record from A to B in order to reduce discrepancies arising from transitions between hospital and primary care?

This is not a new problem its an old one but surely one that could be tackled and eradicated now





Studying Hard Lowers Your Risk of Dementia!

I told you so…

This Blog was originally created for my students on Gerontology programmes at the University of the West Of Scotland. See https://www.uws.ac.uk/study/postgraduate/postgraduate-course-search/gerontology/

So you will understand why I had to post this! It was too good to miss 🙂


More Progress Required on Health and Social Care Integration in Scotland

For the first time in quite a while, I failed to make a post last week. Sorry… 😦

Anyway, back now in a week where the news has been totally dominated in the UK by Brexit. Anyone that knows me will know that as a person working closely with the NHS in Scotland its something I don’t want to see happen. You can see the NHS against Brexit Campaign by clicking the link HERE if you want to understand why. 

So what else has been going on that’s important to older people’s care? Well in Scotland the Audit Commission released its latest report on the progress of Health and Social Care Integration. Rather than me discussing what they say here, the Audit Commission has produced a short video of the highlights from the report that you can view here.


You can read and watch more about the findings of their report by going to this Audit-Scotland Webpage where you will also find some good infographics you can use.

As the report states, there has been some progress but the challenges remain significant.

They also find that success will depend on long-term integrated financial planning and stable and effective leadership and also states that all bodies involved need to tackle these issues as a matter of urgency in order to transform the way services are provided for Scotland’s ageing population.

One of the last statements they make in their news release is  perhaps the most telling

“A collective effort from the Scottish Government, COSLA, NHS Boards, councils and the Integration Authorities is needed for health and social integration to make a more meaningful difference to the people of Scotland.”

Stroke; More Prevention Required


Cerebrovascular disease (CVD) is a condition that develops as a result of problems with the blood vessels supplying the brain. Despite a substantial decrease in rates of death over the last decade across the UK, there were still 4,310 deaths in Scotland alone in 2015.  Every year there are more than 100,000 strokes in the UK each year.
That is around one stroke every five minutes. There are over 1.2 million stroke
survivors in the UK. (Including my Mother-in-Law, which probably explains my interest in this currently.) If you want to know more see The State of the Nation; Stroke Statistics (Feb.2018)

A stroke occurs when the blood supply to part of the brain is interrupted and brain cells are starved of oxygen. This usually occurs because a blood vessel becomes blocked by fatty deposits or a blood clot. Stroke is more common in older people.

The UK  has high prevalences of people exposed to the risk factors associated with CVD such as smoking, high blood pressure, poor diet, lack of exercise and alcohol consumption above recommended limits. Stroke care is also an area of substantial health and social care spending. It represents around 5% of total NHS costs and still remains the fourth largest cause of death in the UK, which is why treating and preventing stroke continues to be a national clinical priority.

So as health professionals what can we do?

There is a themed review from the NHS’s NIHR called “Roads to Recovery” This themed review looks at the configuration of stroke services, identifying stroke and acute management, recovery and rehabilitation, and life after stroke. Are we doing what the review suggests? See https://www.dc.nihr.ac.uk/themed-reviews/stroke-recovery-services-research.htm

Today (5th of November 2018) the Health Secretary for England, Matt Hancock will set out his long-term vision for the NHS and it will focus on preventing illness. CVD and Stroke are one of the most preventable illnesses but we continue to spend 10 times more money on treating disease than we do on prevention. Perhaps its time to consider spending differently and invest in more prevention and in our communities rather than continuing just providing a “national illness service”. Only better prevention will continue the improvement in care and treatment for CVD and stroke and other illnesses that we have been experiencing. What that involves though is not the culture of “victim blaming” which you may hear about today.  See the story about this announcement in the Guardian today HERE

My Worries About Adult Social Care

Last month the Skills for Care: Workforce Intelligence Group published its report on “The state of the adult social care sector and workforce in England”

A summary of some of the highlights of this report is contained in the infographic below.


Caroline Abrahams, Charity Director, Age UK in their recent Blog about this report shares many of my concerns.

About 130,000 new workers are needed each year just to keep the number of care workers in balance with the number of workers we need already. This figure though masks an even bigger problem that faces us in the future.  The numbers of over 65’s in England will increase by 2035 from the current 10 million to around 14.5 million people (about 44%). If the balance between the numbers of older and disabled people remains the same then around 650,000 extra recruits will be needed in adult social care by 2035.

The situation in Scotland is very similar. In March 2018 Scottish Care released a report into the situation in Scotland called The 4 R’s Report it highlighted that the care sector in Scotland is also experiencing a severe recruitment and retention crisis. Care homes employ almost 5,000 nurses (approximately 10% of the total nursing workforce in Scotland) but data included in Scottish Care’s Independent Sector Nursing Data report suggested that there is a care home nurse vacancy level of 31% – up from 28% in 2016.

Approximately 6% of the care home workforce originate from the European Union and a further 6% from other countries. In relation to nurses, this EU figure increases to nearly 8%. Although not directly comparable the English report gives a real figure for their sector pointing out that 104,000 jobs are filled by people with an EU nationality.

As we stumble towards a Brexit cliff, our departure from the EU is bound to have a  significant impact on the care home sector labour market and area of the economy that we are already struggling to recruit to. So its time for action. Care workers play an absolutely vital role in the lives of many older and disabled people and we know we haven’t got enough of them to meet demand even now.

It’s not too late for the UK Government to look again at how care workers from the EU should be treated now and after Brexit. There are many good reasons to reject the notion that Adult Social care is a low skilled job that merits only low pay. Providing care to people in our communities is an essential occupation, on which increasing numbers of older people and disabled people depend.

Age UK has just written to the Home Secretary to urge the Government to exempt care workers from the rules around so-called low skilled workers from the EU post-Brexit. Let’s hope the government are listening, although there is no sign yet… See Business leaders warn of Brexit impact on social care following policy announcement