New Website for @RealisticMed Launched

A new website dedicated to practising Realistic Medicine has been launched this week. Realistic medicine refers to putting the person receiving health and social care at the centre of decisions about their care and creates a personalised approach. It encourages health and care workers to find out what matters most to their patients and clients so that the care of their condition fits their needs and situation. Realistic medicine recognises that a ‘one size fits all’ approach to health and social care is not the most effective approach for the patient or for the NHS.

Its important to older people because it encourages services to adapt to the way in which people with multiple, complex and frequently changing conditions require to access care and support. Those people are primarily over 65. Current models of healthcare services are stretched and there is need to re-examine how we can deliver person-centred and integrated healthcare that embraces both statutory and non-statutory agencies. Cath Calderwood, the Chief Medical Officer for Scotland has said, realistic medicine involves

  • Listening to understand patients problems and preferences;
  • Shared decision making between healthcare professionals and their patients;
  • Ensuring that patients have all the understandable information they need to make an informed choice;
  • Moving away from the ‘doctor knows best’ culture to ensure a more equal partnership with people;
  • Supporting healthcare professionals to be innovative, to pursue continuous quality improvement and to manage risk better;
  • Reducing the harm and waste caused by both over-provision and under-provision of care;
  • Identifying and reducing unwarranted variation in clinical practices

The new website which you can access HERE, features resources, good practice case studies and the contact details of Realistic Medicine Leads within the NHS Scotland Boards.

Helping To Prevent Winter Deaths

Every year that I have been running this Blog round about this time of year I make a post about the alarming rate of UK excess winter deaths. For example this is my post on this topic from last year  https://raymondsolderpeopleblog.wordpress.com/2018/12/16/the-ongoing-tragedy-of-the-uks-excess-winter-deaths/

However this year something different and something positive.

This month NICE and SCIE have worked together to produce A quick guide for home care managers aimed at helping to prevent winter deaths and illnesses associated with cold homes.

You can access the new resource HERE!

As they note, vulnerable people, living in a cold homes are at an increased risk of serious illness or death at this time of year. There new guide explains how some simple preventative actions can help to save people’s lives. They emphasise that care home managers and staff can play an important role in preventing harm caused by a lack of heating.

I think this guide is useful for everyone, not just for Social Care staff so I would urge everyone looking after an older person to take a look and perhaps download and print the pdf version of this guide available from the resources webpage.

Let’s try and get these tragic statistics down.

 

Comorbidity and Dementia in England

If you know me or have to sit through my classes; you will know that I have a keen interest in multimorbidity and its impact on older people. So this week I have to mention that Public Health England (PHE) published a report with findings from an analysis of a sample of anonymised primary care records highlighting the prevalence of diagnosed comorbidities in people living with dementia (in England).

The comorbidities considered in the analysis were hypertension, coronary heart disease (CHD), stroke or transient ischaemic attack (TIA), diabetes, depression, severe mental illness or psychosis, Parkinsonism, epilepsy, chronic obstructive pulmonary disease (COPD) and asthma. The data set used for the analysis was the Health Improvement Network (THIN).

Key findings from the report revealed that

  • 77% of people living with dementia also had at least one other health condition that is mentioned in the list above. So close to 8 people in every 10 diagnosed.
  • Among, people living with dementia hypertension was the most common comorbidity (44%). The prevalence of diabetes, stroke or TIA, CHD or depression ranged between 17-20%, while that of Parkinsonism, COPD or asthma ranged between 9-11%.
  • The prevalence rates for eight of the 10 comorbidities were higher in people living with dementia than you would expect in other people. Only the prevalence of hypertension and asthma was higher in other people.
  • The likelihood of multiple comorbidities was higher in patients with dementia.
  • 22% of people living with dementia had ≥3 comorbidities and 8% had ≥4 comorbidities, compared with just 11% exhibiting 3 or more comorbidities and only 3% exhibiting 4 or more in the wider GP population.
  • At the age of 85 people living with dementia were highly likely to have ≥2 comorbidities compared with other 85 year olds.

The data also shows that different types of dementia lead to different patterns of comorbidities being diagnosed.

Not surprisingly vascular dementia is associated with the cardiovascular conditions, but surprisingly it is also more associated with respiratory conditions than the other forms of dementia.

To see the report CLICK HERE

If you want to know more about this interesting topic then maybe you could read my chapter in the Textbook of Dementia Care.

I know it’s shameless self-publicity!

Improving Well-being Exercise Again!

So twice within a month I am going to post about the same thing and yes you’ve guessed it its exercise. The National Institute for Health and Care Research (NIHR) have released their latest themed review looking at physical activity today.

Their report brings together recent evidence on ways to influence physical activity behaviours in individuals and populations. It focuses on studies funded by NIHR so it is not a comprehensive review. However this is a UK organisation and its research conducted in the UK aims to raise awareness of their collective findings and relate to them to a broader body of research relevant to this country. The breadth of their work is also quite impressive when you consider that the report covers Early Years, Children of Primary School Years, Adults, Older Adults, Workplace Changes, and Changes to the Built and Natural Environments.

What is says about older adults is quite revealing. The review states that

“We don’t know enough from the research about the kind and intensity of intervention which works best, but qualitative evidence suggest the importance of social aspects of exercise, and reassurance around safety and health beliefs. More effort needs to be directed at certain groups most likely to benefit and least likely to take part in initiatives, including those with lower starting fitness and health problems or with weaker social networks.”

Time for health professionals to take heed and focus on these groups then.

To read the report online or download a copy go to: http://bit.ly/2Nm8LGD

I promise that next week I’ll look at something else!