Looking After Your Musculoskeletal Health

This week in Public Health England’s Health Matters Blog they have chosen to focus on older people’s Musculoskeletal (MSK) Health. A good time of year to focus on this as today the outside temperature across most of Scotland today fell to -2 degrees Celsius. So its a high risk of falls day (and a put on your big coat day as we’d say here)

The Public Health Blog focusses on the burden of the three groups of MSK conditions:

  • Inflammatory conditions such as rheumatoid arthritis
  • Conditions of musculoskeletal pain such as osteoarthritis and back pain
  • Osteoporosis and fragility fractures such as fracture after fall

As well as age, the prevalence of MSK conditions is being fuelled by rising levels of physical inactivity and obesity, and poor health habits such as smoking. MSK conditions are a substantial problem for individuals and the NHS. The blog looks at how local authorities, commissioners, healthcare professionals, and the private and voluntary sectors can all contribute towards promoting productive healthy ageing and preventing the onset of MSK conditions. It includes a set of infographics and slides to support local commissioning and service delivery, as well as best practice case studies, so why not have a look and make use of them.  See

https://publichealthmatters.blog.gov.uk/2017/12/06/health-matters-productive-healthy-ageing-and-musculoskeletal-health/

Advertisements

Feeling Lonely and Cold? Unfortunately Your Not the Only One.

scotland-2549450__340

Its the 1st of December and Age Scotland has launched its Christmas campaign, “No one should have no one”. A recent survey they have undertaken reveals that they think about 60,000 people aged over 65 will have no-one to spend Christmas Day with, a 50 percent increase over 2015 figures. Another 80,000 say they feel lonelier at Christmas time than at any other time of year, with those who have been widowed most at risk. They haven’t published the full survey results yet but you can see their report by clicking the link here  Age Scotland Report

They are hoping to highlight the extent of loneliness and isolation in Scotland and encourage people to take action to reduce loneliness in their communities. Interested to find out what you can do? Go to The Campaign to End Loneliness

December also signals now my annual rant about winter deaths because today is the day that we here in the UK start counting!

So why do I go on about this? Well let’s use the Scottish Government’s own figures

There were 20,930 deaths registered in Scotland in the four months of winter 2016/17
from (December to March), compared with 20,509 in winter 2015/16. Comparing the number of deaths in the four winter months with the average for the two adjacent four-month periods, the seasonal increase in mortality in winter 2016/17 was 2,720. This was 130 fewer than the corresponding value of 2,850 for the previous winter.
So what that means is that every year about 2,800 people in Scotland die from the cold.
Just in case for some reason you think that this is OK, its been happening for every winter from 1951/52 when they began counting, and things aren’t really getting better. The seasonal increase of 2,720 in winter 2016/17 was smaller than in most of the previous 65 winters but exceeded the level seen in 10 of the previous 20 winters, and in 5 of the previous 10 winters.
According to the World Economic Forum 2017, we here in the UK live in the 5th richest economy on the planet yet people still die from the cold at an excessive rate in the winter from essentially fuel poverty. This is just embarrassing and shameful and our figures are consistently worse than Scandinavian countries so we have no real excuse.
Want to find out more go to the End Fuel Poverty Coalition

 

Austerity, and 5 Pieces of Advice You Should Listen To

 

poor-1775239__340
Can’t think of anything sadder than seeing older people in extreme poverty

 

Its Black Friday today so most of you will not be looking at this, you’ll be shopping! Its Black Friday though for other reasons after the budget being announced in the UK and no obvious end to austerity or scrapping the cap on pay rises that virtually all UK healthcare workers are experiencing. While that might seem like more moaning the implications for older people in hospital and requiring social care are discussed very effectively in this peice published by the British Geriatric Society on their Blog. So rather than me picking out something have a look at what Dr Eileen Burns, President of the British Geriatrics Society has said.

https://britishgeriatricssociety.wordpress.com/2017/11/23/the-budget-was-a-missed-opportunity-to-help-frail-older-patients-stranded-in-hospital/#more-4923

So as a counter to all that depressive talk about underfunding and its short and long term impact maybe we need to calm down a little and listen to our seniors.

This is another peice from the TED Blog. Yes TED again! You know I am big fan of the talks TED: Ideas worth spreading    So they also have a blog  and this was their Thanksgiving post; “5 Pieces of Essential Life Advice from Seniors” I bow to their wisdom. This is what they said:

  1. Think of hard times like bad weather — they too will pass.
  2. Draw inspiration from all the people you meet.
  3. Love your work — for the salary and for the people.
  4. Find mentors who can guide you and challenge you.
  5. Make the most of less.

To find out more and watch a TED talk about what we get when we listen to people’s stories CLICK HERE

 

Contact Sport and Dogs. Why are they in the Headlines?

I’ve still to watch it but it was interesting to see the topic of head injuries in sport being raised this week in the BBC documentary “Alan Shearer: Dementia Football and Me”. Concerns about head knocks in American Football and Rugby have been a subject of quite a lot of research and concerns in the last few years but Soccer/football has been remarkably quiet about exposure to head injury from heading the ball and other head knocks apparently choosing to ignore the topic despite concerns being raised for at least the last 15 years. I was going to direct you to the documentary page but the BBC has a better resource written by their health editor Hugh Pym that includes links to the documentary on a page labelled £1m for football brain injury research Well worth reading because it also contains a link to a study about American Football conducted in Boston that is perhaps more concerning.

Is it time for change, or is their just so much money in these sports that we are happy to risk the futures of our children?

So for every negative their needs to be a positive so here it is!

Swedish Scientist have just published a huge study that suggests that dogs may be beneficial in reducing cardiovascular risk in their owners by providing social support and motivation for physical activity. The benefits are particularly noticeable for people living alone. I don’t really need to encourage a lot of my friends here, but when we talk about Pet Therapy that’s quite an artificial and temporary construct. Maybe we should just be saying “Go out and get yourself a dog!”

Dying Comfortably

Last month saw the publication of one of those papers that helps confirm something that you always believed you knew. So what did it confirm?

Very old people are more likely to die comfortably if they die in care homes or at home when compared to hospitals. The study carried out by a nursing team at the University of Cambridge found that the oldest old do not always receive effective symptomatic treatment at the end of life. While that is true in most settings up to four times more are likely to die comfortably in a community setting when compared to hospital. So what’s the message? Training for end of life care needs to be improved for all staff, at all levels but perhaps more telling is the need for governments (not just in the UK) to review the funding of long-term care so that more people have the opportunity to die in their home/ care homes than currently so that late admission to hospital is less likely. Not a new message but maybe its time to sit up and take notice. To download the paper go HERE

Sticking with the same topic an End of Life Care resource called “Let’s Talk About Death and Dying” has been produced by Age UK and the Malnutrition Task Force. The materials were produced in a response to a survey showing yet again that conversations about death remain a taboo topic. The new video is below:

 

What’s Been Happening at NICE?

man-getting-better

This is probably the longest gap in posts since I started this weekly Blog so for regular followers my apologies for missing last week completely. I was unwell last week and didn’t feel well enough to post, which was followed by a very busy week when I just ended up each night too tired to write.

Hopefully, normal service is now resumed and I might even try and do an extra post this week.  So the question now that I am back, has to be why am I drawing your attention to the National Institute of Healthcare Excellence (NICE).

Well as many of my students know I have not been a big fan of what they put on their website until quite recently. I never thought that it was enough to just release Guidance and not really do much to show or explain how it should be used. However, that’s all changing. I am a big fan of their Pathways, very handy if you are trying to work out what ideal care in the UK should look like for particular illnesses and conditions. I am also probably an even bigger fan of their Clinical Knowlege Summaries which are really useful when you are considering what to do in practice. They are almost like checklists for what you should be doing in particular circumstances and incorporate all the appropriate NICE guidance.

Now they are doing it again. They have started producing a series of Quick Guides, developed jointly with the Social Care Institute for Excellence (SCIE) which are based on NICE guidelines and health and social care quality standards (Unfortunately the English ones and not the Scottish ones). There aren’t many yet but it’s really worth keeping an eye on these as the collection grows particularly if you are involved in integrated care, social care or providing care home care.

The most recent one is for intermediate care services, which help people to recover from illness or an accident, to regain independence and to remain in their own homes. This new guide gives people who use the services and their families and carers an overview of:

  • The types of service available
  • The four stages of intermediate care
  • The professionals involved in providing care

A new place to look for well-written evidence-based and useful materials.

 

 

Oncogeriatrics? My “What’s wrong with the BBC’s Health Tracker” Rant

This week I am going to refer to another Blog piece from the British Geriatrics Society because it’s written by someone working locally in the West of Scotland. Dr. Kirsty Colquhoun has been a consultant geriatrician, working in Glasgow, since August 2015 and her specialty is Oncogeriatrics. Not a term I am either familiar with or like but let’s just go with it. In her blog she discusses the BGS Oncogeriatrics Conference on 7 December 2017 at the Wellcome Collection in London. Worth a look even if it’s just to get your hands on the Cancer Services Coming of Age Report from 2012. I may not like the name chosen for what she does but I would support her in her efforts to see Comprehensive Geriatric Assessment used in cancer care as well as other areas where it’s also extremely useful. See this Cochrane Review   about its use.

This week also saw the release by the BBC of their NHS Tracker. The tracker uses the latest published data on performance against three key NHS waiting-time measures:

  • A&E treatment
  • cancer care
  • planned operations and care, such as knee and hip replacements

and pulls this data from currently published NHS and Government office data to allow comparisons across the UK, but be warned there are differences between how the targets are measured in each part of the UK. So is this a good thing or a bad thing? My own feelings are neither of these. It’s missing the point completely. Of course, the NHS is missing its targets. Its grossly underfunded, short of staff and very short of staff in key positions, like radiology, gerontology and more…. Do we really need another measure of how bad things may be getting, or should we tackle this! (chronic underfunding when compared with other westernised economies)

 

2012-07-17-03-31-04-pm1

From https://epianalysis.wordpress.com/2012/07/18/usversuseurope/