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

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






Why is it Hard to Talk About Dying?

Last week the Royal College of Physicians (RCP) released a new report that explores the reasons why doctors and other healthcare professionals find it hard to talk to their patients about dying.

The report called “Talking about dying: How to begin honest conversations about what lies ahead” is downloadable RIGHT HERE

The RCP report is based on conversations with doctors at all levels, patients and carers, and medical organisations and reveals the barriers that stand in the way. It offers some solutions and resources to help, including a ‘mythbusting section’ debunking common but erroneous beliefs that we have about these kinds of conversations

Four English hospitals leading the way in supporting end-of-life care (EOLC) have contributed good practice case studies to the report.

One of the major issues identified within this report and the one that much of the UK media is reporting most frequently is the need for healthcare professionals to begin conversations about planning for end-of-life care nearer the time that patients are given a terminal diagnosis. They point out as would I, that there are multiple opportunities in a patient’s healthcare journey to start honest conversations even earlier than this, when discussing future goals and treatments whether that’s at outpatient appointments, hospital admissions, in social care settings or best of all out in the community.

And why are these conversations so important?

Because the sooner we have these early conversations the sooner we are allowing those we care for opportunities for choice and control over the remainder of their lives. Like many others I would call for anyone with a known life limiting illness to consider creating an Anticipatory Care Plan to manage their health and well-being at the earliest opportunity. Why is explained quite nicely in the video.

Scotland’s Anticipatory Care Planning Toolkit is accessible HERE

For more about this topic its also worth taking a look at the Death Cafe site

Maybe this will inspire you to host your own community Death Cafe!

“The Care Home Journey”; a New Resource


Last month the Royal College of Nursing (RCN) launched a new resource for nursing staff based in care homes. With over 30,000 nurses in the UK working in care homes and care homes having a greater number of beds that the NHS then a resource that is designed to bring evidence based information to nurses working in this sector interactively is long overdue.

The resource called “Care Home Journey: An online resource to support nursing care in older peoples care homes” aims to bring together evidence based guidance on on typical clinical and social problems that care residents might experience. It presents this information through the use of 3 characters whose journey’s you can follow.

They are John, Seema and Jane. and the journey’s go all the way from pre-admission to end of Life Care.  Each section of the journey demonstrates the role of nursing staff when supporting the resident, their families and nursing colleagues at each stage in the fictional resident’s journey. Worth an explore if you are working in this sector since the resource is both FREE and Open Access.

To access the resource CLICK HERE


In Advance of Armistice Centenary Day

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St John’s Ambulance Brigade Nurse 1914

This year Remembrance Day on the 11th of November will mark the 100th anniversary since the end of the First World War. As part of the commemorations, Britain and Germany are joining in a call for bells of all kinds to be rung globally (at 12.30 hrs GMT/13.30hrs CET/12.30 local time) to replicate the outpouring of relief when 100 years ago the guns finally fell silent. The US Centennial Commission has already made a similar appeal to Americans.

For other events and activities taking place to mark the Centenary the following website is useful, click here on  Centenary News.

Of particular interest to me is a  Royal College of Nursing (RCN) online exhibition showcasing the lives of nursing staff during the First World War, which won the Women’s Network History Award for 2018. Called “Service Scrapbooks: Nursing and Storytelling in the First World War” this project digitised and transcribed photographs poems diary entries and illustrations ranging for 1909 to 1919. To go to it click here

this new archive contains a collection of digitised slides from Scottish Women’s Hospitals which is a haunting glimpse into life in a field hospital 100 years ago.

A very moving archive full of personal views of the war by nurses who were there.

We Love BBC Music Memories

On Friday the BBC hosted its annual music day and on it launched a new website featuring music designed to trigger memories in people with dementia. Called BBC Music Memories  The site is designed to use music to help people with dementia reconnect with their most powerful memories and has been inspired by an ever-growing body of research on the beneficial effects of music in helping those with dementia. See Music Based Therapeutic Interventions for People with Dementia

In developing tis site they worked with the Scottish-based music and dementia charity, Playlist for Life, featured in the video below.


The playlist for Life app can be found here

The new BBC site is being supported by leading dementia organisations including Alzheimer’s Society, Alzheimer Scotland, Dementia UK and Carers UK. They are encouraging their many members to visit this new website to try out music memories for themselves. You can then take part in a survey to help them to discover the nation’s favourite music memories.

BBC Music Memories features tracks from 1920 to 2017 so there is there’s something for everyone. The site hopes to encourage inter-generational use so people of different ages can use the resource together to listen and talk about their own memorable music and the thoughts it triggers.Once users have made and shared their own playlists the BBC aim to build a shared database to create a unique resource to help others. It is incredibly simple to use on any digital device (PC, tablet or smart phone). It also has a simple user guide along with helpful links to further dementia support resources.

For more about the project see BBC Media Centre Report

The BBC also has a suite of other dementia support tools , including the award-winning BBC Reminiscence Archive and Your Memories.

My Blog is 3 Years Old Today!

birthday-492372_1280This is a bit of a landmark because when I started out this blog it was really as an experiment to see what I could do to keep my own MSc in Gerontology students up to date with developments in older people’s care occurring during their programme.

So 3 years on and I have posted 162 times. The site has been viewed by 2,299 different people, I have 33 followers and the most popular day to come to this site is a Monday (about 20% of all viewers)

So thanks to everyone who visits and spreads the word about this blog. It’s gone well beyond the “classroom” although I know many of my students do visit regularly. Please keep following and visiting. And remember that despite everything that’s going on, things are getting better.

For example; in the last 5 years across European mortality from the four major noncommunicable diseases (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases have been on a 2% decline per year on average based on the data from 40 of the 53 countries in the European Region. In addition, a WHO 2017 progress review established that the WHO European Region is likely to achieve its target of reducing by one-third premature mortality from non-communicable diseases through prevention and treatment and promoting mental health and well-being earlier than 2030 and will probably exceed it.

See the WHO Factsheet by clicking here

Fantastic news that you probably haven’t heard.