One in Five UK Hospital Patients are Harmful Drinkers

A team mainly from Kings College in London conducted as part of the first author’s MRC Addiction Research Clinical (MARC) Fellowship, has found that 1 in 5 in-patients in the UK hospital system uses alcohol harmfully, and that 1 in 10 is alcohol dependent.

They conducted a systematic review and meta-analysis that looked at studies of any design that reported the prevalence of one of 26 wholly attributable alcohol conditions defined by the WHO’s International Classification of Diseases, Version 10 (ICD‐10).

They looked at 124 studies which were all conducted in one or more of the constituent nations of the United Kingdom and in an in‐patient setting (general wards, intensive care units, accident and emergency departments or mental health in‐patient units). The 124 studies meant that they were reporting on a total of 1 657 614 patients.

Having arrived at what is a shocking statistic they have rightly suggested that hospital staff need to be skilled in the diagnosis and management of alcohol‐related conditions given the number of people that they will see as inpatients. They have also pointed out that formal screening for alcohol‐related conditions in hospital remain low and that needs to change

Given the fact that other less prevalent diseases such as diabetes, are routinely screened for and often have dedicated in‐hospital specialist care teams their study provides weight  for increased routine universal screening and support to improving everyone’s training concerning alcohol‐related conditions given this high frequency of encounters.

This study is very pertinent given the UK government’s development of a new alcohol strategy and the NHS 10‐Year Plan which included funding allocations to combat alcohol‐related conditions.

Last year figures suggested that at least 41 English hospitals do not currently have an alcohol care team (ACT’s) in place. This is despite the 10 year plan including a commitment to place ACT’s in hospitals with the highest rate of alcohol dependence-related admissions (according to this study that will be all of them!) although the plan for increasing ACT’s, does not seem to have to any material funding.

To view the whole report see

Roberts E, Morse R, Epstein S, Hotopf M, Leon D, Drummond C. The prevalence of wholly attributable alcohol conditions in the United Kingdom hospital system: a systematic review, meta-analysis and meta-regression. Addiction. 2019 Jul 3 [Epub ahead of print]. doi: 10.1111/add.14642. PMID: 31269539

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Focusing on Retirement

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Thought I’d “borrow” again from the ideas.ted.com site which published a very interesting Blog recently on the topic of retirement and its potential effects on the brain. It reports on emerging research that seems to suggest that retirement could lead to a decline in your cognitive function. However, its not quite as simple as that and many people thrive in their retirement. This Blog and the accompanying TED talk by Professor Ross Andel of the University of South Florida in Tampa make a number of suggestions about what you need to be aware of and what you need to do to stop the decline in speed of processing one of the main indicators of the ageing of the brain. One thing he suggest is to forget the idea that retirement is a permanent holiday and look at it more as a personal renaissance. I am therefore beginning to look forward to rediscovering myself!

On a more general note the reality of retirement in the UK in the future may be a more complex situation than we face currently.

In 2017 the BBC Money Box Programme made a series of programmes on the topic of The Death of Retirement which is worth spending some time listening to.

Challenges in Providing End of Life Dementia Care and More About Pets!

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Image by Sven Lachmann from Pixabay

A paper published last year was brought to my attention by our friend the Mental Elf, part of the National Elf Service an Oxford University spin-out company founded by information scientists Douglas Badenoch and André Tomlin, who have been building evidence-based healthcare websites since the early 1990s. Douglas and André share a vision for making evidence-based research more accessible and usable for busy health and social care professionals

In a recent Blog published on the 26th of June their team looked at the findings of the following paper

Fetherston, A. A., Rowley, G., & Allan, C. L. (2018). Challenges in end-of-life dementia care. Evidence-based mental health21(3), 107-111.

which you can access by clicking here.

What the paper found was that people with dementia and their families should be supported to discuss end of life care preferences whilst the people with dementia still have the ability to do so. However, research is needed to address when these discussions should best take place and who should initiate these conversations.  They have highlighted that current policy and practice has focused on living well with dementia, but this cannot be at the expense of failing to support people dying well with dementia. Both the Blog and the paper are worth a closer look.

Continuing on the theme of Dementia Care something completely different. Following a very successful event held at the University of the West of Scotland where I work on the use of animal assisted therapies in dementia care my colleagues published their own blog about the event on the British Society of Gerontology’s Blog which is called Ageing Issues. You can read their Blog “Dementia & Multi-Species Caring: Current Practice & Future Possibilities” at

https://ageingissues.wordpress.com/2019/06/27/dementia-multi-species-caring-current-practice-future-possibilities/

Six Ways Carers Can Fight Burnout

I missed a post again last week and I’ve also missed another Friday since. This is possibly the longest break between posts in the 3 plus years I have hosted my own Blog.  Unfortunately that means that I  didn’t post anything at the end of Carers Week which fell between 10 – 16 June 2019 this year so to make up for that I am going to post the link to a great Blog that was posted on the 20th of June by Ideas.Ted.Com which is the Blogging site of the people who bring you TED Talks

Called “Caring for a loved one is hard work — 6 ways you can fight burnout” its a useful set of tips for anyone who is a carer. The links to 3 associated TED talks are also on the page if you want to watch rather than read.

Just as a contrast here is another TED talk but this one is about Domestic Workers- they’re the nannies, the elder-care workers and the house cleaners who do the work that makes all other work possible. Too often, they’re invisible, taken for granted or dismissed as “help,” yet they continue to do their wholehearted best for the families and homes in their charge.

More Insight into Gender Equality and Health

Today The Lancet has published a series of papers on on Gender Equality, Norms, and Health. This is a collection of five papers, led by Gary Darmstadt of the Stanford King Center on Global Development and his colleagues, that provides a new analysis and insight into the impact of gender inequalities and norms on health, and the opportunities that exist within health systems, programmes, policies, and research to transform gender norms and inequalities. The series of papers highlight that potential advances in health and development are thwarted by systemic neglect of gender by health institutions across the globe.

They also show that the same systems that perpetuate these injustices against women and girls also harm men and boys and gender and sexual minorities. As a result they affect a broad array of health outcomes for all people. Through this series of papers the authors hope to inform the global health community of effective actions to recognise and transform gender inequalities, and their intersections with other social inequalities—including those related to age, race/ethnicity, religion, and socioeconomic status.

Their ultimate goal is to catalyse actions to enable all people to live to their full human potential, by upholding human rights and improving health and well-being for all.

You can access the papers and commentary around them at

https://www.thelancet.com/series/gender-equality-norms-health

You are likely to hear a lot more about this work via mainstream media in the next few days so if it sparks your interest and you want to avoid the hype, remember to go back to the source.

So why does this matter to older people?

Ageism and sexism in health services affects the quality of care, patient-provider interaction, patient self-perceptions, and the planning of health education programmes for older women. The stereotyping of older women in health care encounters, although often subtle, can have far-reaching effects on the health status of older women (Sharpe, 1995)

That’s without discussing ageism towards women in the workplace, media and elsewhere….

Happy 30th. Birthday “Nursing Older People”

Thought I’d join the Editor Lisa Berry (@RCNi_Lisa) in wishing her journal Nursing Older People a Happy 30th Birthday since it falls in June. I’ve been a subscriber since 2013, possibly a little longer. Just occasionally my colleagues, students and former students get something published in it. So thanks for being there and spreading the word about some of the great things they do.

Unfortunately you generally need to subscribe or buy it to get to see the articles but just occasionally they make some items freely available and that’s why I am bringing it to your attention this week.

Ahead of the RCN Congress they released a free to access frailty resource that contains an RCNi Learning module called “Reframing frailty as a long-term condition”

Some video case studies on using the Comprehensive Geriatric Assessment (CGA) tool in both acute and community settings and some further advice on managing frailty are included. I think this resources might be due to close soon, so pay a visit and take a look while you still can. It’s at https://rcni.com/features/frailty-resource-collection-84906#.XOP-wrRGOtM.twitter

Time to Raise the Equality Flag (Again!)

Late again with this post. Not sure now why I promised a new post every Friday when now I rarely manage to post it on time. 😦

Enough moaning about my own tardiness, this is more important!

Earlier this month the International Longevity Centre (ILC) released a report by their own  researchers and other researchers based at University College London (UCL), and Cardiff University. The work was funded by the Wellcome Trust. The report called “Raising the equality flag: Health inequalities among older LGBT people in the UK” which you can download from HERE pulls together the results from a  project conducted across two phases: a scoping review of existing evidence and a new analysis drawing on
several existing UK datasets.

Their research, like previous research concluded that a lifetime of prejudice and stigma is leading to worse physical and mental health, poorer access to health and social care, as well as greater levels of social isolation and loneliness among older LGBT people Moreover, older non-heterosexual men are more likely to be living with a long-term limiting illness and have lower overall life satisfaction.

These health inequalities have been ongoing issues for many years and while there may some improvement in attitude there seems to be very little improvement on outcomes.

So what needs to be done? Well to reinforce the points that this report makes we need
action to

(a) ensure mainstream health and care services are inclusive, i.e. they provide environments where older LGBT people feel safe and comfortable (Are they not supposed to be able to do this already?)

(b) Develop a national standard or quality assurance framework around equality and diversity training for the needs of older LGBT people.

Presumably because we aren’t doing (a) already 😦