Do We Still Want Docile?

Sorry I went “missing” for a week, nothing unfortunate, just a holiday where I didn’t have the time or reliable access to the internet to sort my post out. I think its quite a while since I went a whole week without posting.

I’m back this week and many thanks to Kate Swaffer for bringing this to my attention. This month saw the release of a Human Rights Report into misuse of anti-psychotic medication in dementia care in USA

The report ‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia, estimates that every week in US nursing facilities, more than 179,000 people, mostly older and living with dementia, are given anti-psychotic drugs without a diagnosis for which their use is approved. Often, nursing facilities use these drugs without obtaining or even seeking informed consent. Using anti-psychotic medications as a “chemical restraint”—for the convenience of staff or to discipline residents— violates US federal regulations (and regulations in most EU countries including the UK) and may amount to cruel, inhuman, or degrading treatment under international human rights law.

Yet another reminder of the dangers of these drugs, a problem very effectively highlighted in UK healthcare on the publication of the Banerjee Report in 2009.

Things have been improving in the UK but it is still an issue worth highlighting and bringing to people’s attention. Particularly bearing in mind that the Department of Health in 2012 said antipsychotic use was still  “resulting in as many as 1,800 unnecessary deaths per year.” despite the improving awareness of the problem. Note that overprescribing of anti-psychotics is not confined to nursing homes. In fact many nursing homes have arrangements in place to minimise all over-prescribing that many healthcare professionals could learn from. See the HALT project in Sydney and this deprescribing anti-psychotics algorithm from Ontario if you want some inspiration for reducing anti-psychotic prescribing for the people living with dementia that you care for.

So I’ll leave you with a final thought,

How could we possibly think that it is a good idea to treat stress, distress and unmet needs using sedation?”

 

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Sláinte: Alcohol Consumption and Older People

Well, it was food last week so this week let’s turn our attention to drink.

NHS Scotland this week released a new report, Hospital Admissions, Deaths & Overall Burden of Disease Attributable to Alcohol Consumption in Scotland that indicated that more than 3,700 deaths in Scotland could be directly linked to alcohol consumption. In addition, more than 41,000 people were admitted to hospital as a result of consuming alcohol. These findings overall show that alcohol has a wider impact on health than many people think, supporting the Scottish Government’s case that minimum alcohol pricing. This starts in Scotland in May 2018 and given this state of affairs has to be at least worth trying.

So why is this important to older people? Well, you have to look at alcohol consumption in the UK. In those that drink alcohol (about 83% of the total population) Drinkers aged 65+ years drank more frequently than any other group and were also more likely than any other age group to have drunk alcohol on 5 or more days in the previous week (24% of men and 12% of women) compared to 3% of men and 1% women aged 16 to 24 (Office of National Statistics, 2017). See Drinkaware if you want a more comprehensive view

There is an alarming lack of recognition of the extent of this problem in frontline healthcare staff who remain more likely to associate heavy drinking with the 16-24 age group, perhaps because they are more likely to binge drink, with all the problems that cause rather than older people steadily drinking more.

So it was really good this week to come across a new resource called Vintage Street Not the snappiest or most obvious name, unfortunately, that is purpose-built for people over 50 who are concerned that they are maybe drinking a little too much. It offers a range of online advice that older people, their families, employers may find useful. It also lets you know how to get in touch with the 5 Drinkwise Age Well centres.

Seems appropriate to put these here so you can check yourself out before you visit the site!

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Digging is Good, Hunger is Bad!

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Congratulations firstly to Sarah Noone @SarahNPhD who had her first article about her PhD work published in the Journal Ageing and Mental Health. Called Digging for Dementia it about the experience of community gardening from the perspectives of people living with dementia. You can see her work by Clicking Here

So after the positives, unfortunately a negative as I’ll add my support to the BGS Call for urgent action on hunger and malnutrition amongst older people. See their Blog Post here.  The UK governments All Party Parliamentary Group (APPG) on Hunger’s Report published this week highlights that malnutrition is most likely to arise among older people following an accumulation of setbacks which leave them unable to access food easily. Like winter detahsits hard to understand how we got to a situation where we put the most vulnerable people in our community at such high risk.

Finally, a warning for all my students the National Institute for Health and Care Excellence (NICE) are currently consulting on updating their guidance for Dementia.The new guidnace will be called  “Dementia – assessment, management and support for people living with dementia and their carers” and is due to be published in June 2018. You can come back and look here nearer the publication time as no doubt It will feature since its so important to what I teach people about.

If you or your organisation want to contribute to the consultation it is at Dementia Consultation

Is an Effective Dementia Drug Treatment Getting Further Away?

stop medications

Sad to hear this week that Pfizer, the worlds largest research-based pharmaceutical company, so they say, are halting the development of any new drugs designed to tackle Alzheimer’s and Parkinson’s disease, with the loss of 300 jobs from their centres in Cambridge, UK; Andover, Mass., and Groton, Conn. Despite heavily funding research efforts into potential treatments in the past, Pfizer has faced high-profile disappointment in recent years from a number of different drug trials. This is a huge blow in the search for an effective drug to halt or slow both diseases just as some huge leaps are being made in other areas of diagnosis and treatment.

Any successful drug in this area would be seen by many in the pharmaceutical industry and others as having a multi-billion pound (dollar) sales potential and ongoing trials are a crucial beacon of hope for many people living with dementia and their families, so recovering from this may take a long while. Maybe we should not be leaving these decisions to private companies, perhaps its time to look at a different model for funding drug research that would make medicines more accessible to all. The World Economic Forum looked at this back in 2015 and this article, Can Megafunds Boost Drug Research?, certainly makes interesting reading now as we struggle to find new antibiotics, as well as new neurological enhancing drugs to tackle one of the World’s most costly disease processes. I’d be interested to hear what other people think.

Totally different topic and this is via the BGS Blog. This week they have published a collection of 8 articles from the last 10 years that demonstrate the way in which the application of qualitative research methods within the social science disciplines of sociology, anthropology and social psychology can enrich understanding of ageing and illness. Does sound like the greatest set of reading ever, but I am sure that if you look there will be something to love on the list!

See https://britishgeriatricssociety.wordpress.com/2018/01/18/qualitative-research-in-age-and-ageing/

Unfavourable Views of Hospital Care in England are Strongly Linked to Nurse Numbers. Is That a Surprise?

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Now at a time when the Government and all of the national media looks hell-bent on convincing everyone here in the UK that the NHS is broken, rather than being underfunded and under-resourced in terms of staff and beds; there has been very little space given to the published results of the 2010 NHS Survey of Inpatients and a BMJ paper published this month which shows that Patients’ unfavourable views of hospital care in England are strongly linked to insufficient numbers of nurses on duty, rather than uncaring staff, indicates observational research. The paper was published in the online journal BMJ Open so it’s not exactly hidden from journalists politicians etc.

Perhaps pointing out that the number of vacancies in the NHS has soared by 15.8% over the last year, prompting warnings that the service is facing “desperate” problems of understaffing is not what politicians want you to hear. Particularly concerning were the figures for England released in July 2017 by NHS Digital that showed that the number of full-time equivalent posts available rose from 26,424 in March 2016 to 30,613 in March 2017 – the highest number on record.

What this has done is fuel a public view that the NHS is worse than it used to be and that staff are less caring etc. The reality is really very different as any9one working for it knows. Can we please celebrate the success of the NHS at 70 (which happens on the 5th. of July 2018) and stop trying to undermine it. Yes the NHS does need to be reformed, but it would help to see it properly staffed first.

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This week I was involved in publishing a Blog for “Ageing Issues” The blogging space for members of the British Society of Gerontology (BSG) where they discuss contemporary issues raised by ageing societies. The blog was about the BSG small event we held here @uwshealth in Hamilton in August. To read more about it see:

https://ageingissues.wordpress.com/2018/01/09/past-present-and-future-supporting-novice-researchers/

Another great find this week. The Joseph Rowntree Foundation this month launched a new Data Information Source that collects together the latest UK poverty data, statistics and analysis from the JRF’s Analysis Unit. This page is a great tool for to finding information about poverty rates and related issues in the United Kingdom and you can access it from here:

UK Poverty Data

 

Austerity, and 5 Pieces of Advice You Should Listen To

 

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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

 

International Day of the Older Person 2017

The International Day of Older Persons is observed on October 1 each year. So today is the day and I thought I should mark it.

This year’s theme is about enabling and expanding the contributions of older people in their families, communities and societies at large. It focuses on the pathways that support full and effective participation in old age, in accordance with old persons’ basic rights, needs and preferences.

The UN has stated that this year’s theme underscores the link between tapping the talents and contributions of older persons and achieving the implementation of the 2030 Agenda for Sustainable Development and the Madrid International Plan of Action on Ageing, which is currently undergoing its third review and appraisal process.

The message for this year from the United Nations is here 

The World Health Organisation also has a message on their Ageing and Life Course pages. Given that their focus this year is on Universal health coverage it’s a good day to watch this!