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
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)
This week saw the start of the Scottish Mental Health Arts Festival 2017 which takes place from the 10th. to the 29th of October across the country There are lots of interesting events on of relevance to older people experiencing mental health issues. There is so much on, that you are probably better searching for something local yourself to go and see. Whatever you do I am sure it will be enlightening.
I also found “Chief cook and bottle washer” which is a film created by the Bournemouth University PIER partnership and 11 male carers over the age of 85. in the video, These older carers share their insights on being an older carer; how life has changed and their key messages for practitioners.
Before you watch the video it’s worth noting that carers over the age of 85 are the only demographic of carers where men outnumber women (59%). Men are more likely to become carers in older age than at other times in their life and usually as a result of caring for their partners. As such, older male carers are more likely to live with the person they are caring for. Many carers have physical and mental health issues themselves and evidence shows that caring for someone further increases the likelihood of isolation, loneliness and depression and physical health problems. In the future, the number of older carers will increase so this is a timely film about a little-researched group of careers. A theme amongst the carers’ experience was the loss of free time and many of the men spoke of feeling increasingly isolated. Time to act? Even if we don’t act now we need more projects and research like this.
This week saw the publication of the Scottish Health Survey for 2016. Possibly the most significant piece of news from this for older people was the following information reported on BBC Scotland’s Health Page Scotland’s health: What we learned
From the report, they have stated that amongst adults men were significantly more likely than women to be overweight including obese (68% compared with 61%). Worryingly it was adults aged 65-74 who were most likely to be obese (36% of all adults this age). The average BMI (Body Mass Index) for both Scottish men and women was 27.7, up from 27.0 in 2003.A BMI of 25 or less is said to be normal and 25 to 30 is overweight.
A BMI of 25 or less is said to be normal and 25 to 30 is overweight.
Obesity was lowest in the 16 to 24 age group (14%) but it doubled to 28% in the 25-35 range. The largest jump between age groups. It would appear that while the message to reduce obesity in Scottish children is getting through to the public the same cannot be said of the message about the need for our older people to avoid obesity and stay active to reduce the likelihood of cardiovascular disease and diabetes. The Scottish Government are planning an ambitious new strategy to improve Scotland’s diet and help address obesity. Let’s hope they include older people in their plans.
For information about staying healthy in old age, this page on the Age Scotland site is useful
Perhaps a missing element from this survey is more detail on the mental health of older people. More will be reported about this but it’s perhaps worth remebering that up to 40% of people over the age of 65 experience mental health problems and about one-fifth of all suicides happen in older people. Last month Alistair Burns, the National Clinical Director for Older People’s Mental Health and Dementia took to social media to announce the launch of “A Practice Primer on Mental Health in Older People” a document which highlights for primary care health workers in particular GP’s, symptoms often attributed to ‘old age’ but where a mental health diagnosis and follow-up may be more appropriate.
You can read what he said here and find the link to the document he is discussing (if you didn’t click the link above already) In the document he talks about this film that looks at Improving Access to Psychological Therapies. I am with him on this!
Since it’s all over the UK news this morning I think I have to mention Safe Staffing Levels and the current shortage of healthcare staff across virtually all sectors of healthcare in the UK. Today the RCN have released their Safe and Effective Staffing Report, to a flurry of publicity about this issue. (to see their Safe Staffing page, which includes the report click here )
Some 30,000 staff, including midwives and healthcare support workers, took part in this piece of online research and the RCN describes their stories as “desperately sad”. It’s quite an emotive topic surrounded by political spin (See this BBC article for example) but in the end, its primarily older people who are affected by these shortages and that’s not always clear. In a previous report back in May, the RCN stated what it thought should be done to tackle this ongoing crisis. I wish this was a new issue, I wish I could see some positive steps to improve the situation but so far there is not much progress (See my own post from March last year!) You should note also that this is not just a Nursing crisis the same is true for AHP’s and Doctors.
OK onto better news… This week the WHO launched its Integrated Care for Older People Guidelines (ICOPE, maybe the best acronym ever), asking for individual and systems level changes to be undertaken by all member countries to respond to the needs of older people with a focus on reorienting primary care providers and health systems to respond to the great diversity in physical and mental capacities of older populations and provide care that is person-centred and integrated across health care services, settings which is coordinated with social care. The UK has been struggling with this for a number of years now but progress has been made. If these guidelines are adopted by more countries the hopefully responsive integrated care won’t be an innovation it will be the way all health care is delivered.
Watch out USA one of its key platforms is Universal Health Coverage
Found this about Integrated People Centred Care and I love it. This is what everyone needs to know as healthcare reforms.
Back in July I posted about a report done by my colleagues here at UWS’s @AlzScotCPP on the need for improvements in housing required in Scotland to support people who have dementia now and into the future. See my post here Well this month saw the publication of a larger report by the Local Government Association for England which has stated that with one in five of the overall population in England set to be over 65 in a decade, a “residential revolution” needs to occur to provide more homes that support our ageing population. They have suggested that we need to increase the number of specialist homes for older people by 400,000 units in less than 20 years to catch up with places like the USA and Australia where a more developed market exists for retirement housing. Cllr Martin Tett, the LGA’s Housing spokesman pointed out that councils cannot tackle this issue alone. Support from government, which incentivises housebuilding and provides councils with the funding and resources they need, is crucial to every local authority’s efforts to support positive ageing. You can read more about this issue and download the full report at
You can also watch a short video about the report here:
Well done RCN Older People’s Forum and My Dementia Improvement Network for getting behind a campaign to raise awareness of identifying delirium not just in hospital but also within the community. Older people with multiple long term conditions are particularly vulnerable to delirium but are also the most likely not to have it spotted until the possibility of a poor outcome is more likely. To find out more about becoming a delirium champion and get a resource pack to help raise awareness of the need to identify delirium early visit this RCN page.
I just wished they hadn’t used the label “champion”. Particularly as someone involved in training Scotland’s National Dementia Champions; who are already encouraged to raise awareness of this issue.
Still, it’s a very appropriate issue to highlight during Dementia Awareness Month
Amongst all the worldwide weather chaos that we are currently experiencing I think I should also highlight the biggest one and the one that has the most impact on older people and that is the East Asia Floods. Although its probably the least reported it already has the most deaths reportedly caused by it and has affected by far the most people. The burden in such chaos often falls on older people. To learn more and maybe to contribute to the relief fund please visit Age International South Asia Floods