Well, I am late posting again this week although I’ve got a list of very good excuses that I won’t mention.
There was only one topic that I wanted to share anyway and that’s because it is a cause I was certain to support. On the 12th of February BGS Nurse and AHP Council released a position paper on the professional workforce development and educational requirements of those supporting the health and care of older people in the UK.
They believe that all health and care staff and professionals require knowledge and skills to enable them to work effectively with older people an assertion that is in line with recent position papers from the British Geriatric Society (2018) on the Primary Care of Older People which calls for increased education and training.
Their work identifies 5 levels in the workforce where they feel specific knowledge and skills are required. I would suggest taking a look, particularly if your career lies predominantly in this sphere of care. Their position statement can be found HERE
I’ll pick out one thing because it is so important!
All health and social care focused undergraduate curricula, where graduates will work with older people, the focus on the older population must be recognised as the golden thread that runs throughout each programme. Education curricula regulators need to respond to this call as do Higher Education Institutes who must make it a priority to review their course content to reflect this new horizon of population demand and long-term supply need. The BGS cannot reinforce enough the urgency for providers to respond now and ensure fit for the future undergraduate curricula are in place.
Three years of Blogging about the need for this and still waiting for transformation.
The paper highlights that missed general practice (GP) appointments are a significant risk marker for all-cause mortality, particularly in patients with mental health conditions. People with mental health conditions who missed appointments risk of death also increased with the number of appointments they missed. To the point that missing more than 2 appointments per year placed them at 8 times greater risk of dying (in the next year) than those who missed no appointments. They died prematurely, commonly from non-natural external factors such as suicide.
The research led by the University of Glasgow, used routinely collected primary care data from 824,374 patients across Scotland during a 3-year period from September 2013 to September 2016. They then took this information and linked it to the Scottish death records for patients who had died within a 16-month follow-up period.
The study also showed that patients with a greater number of long-term conditions had an increased risk of missing GP appointments, despite controlling for number of appointments made thus also placing them at risk. What is not obvious in the study is that that if you missed a GP appointment and had dementia and another long term illness this also placed you at a significantly higher risk of death.
So what can we learn from this. As the authors state
“…missing multiple appointments provides a risk marker of all-cause mortality even after you control for other factors. Also… GPs, the acute sector and other NHS services should consider how best to facilitate engagement of patients with patterns of repeatedly missing appointments because for non-attenders the existing primary health care appointment systems is ineffective.”
So rather than vilify people who miss GP appointments as time wasters who need to be penalised/punished maybe its time to ask “Why are you not here?”
An interesting view to take on this issue is provided by the Medical Defence Union who have an item on their website called
I would suggest reading it, particularly if you are a practice nurse or work in outpatients.
In common with other countries, more people in the UK die in the winter than in the summer. Health Protection Scotland and other agencies point out that the deaths can often be attributed in part to cold weather directly (for instance deaths following falls, fractures, and road traffic accidents), in part to cold weather worsening chronic medical
conditions (for example, heart and respiratory complaints), and in part to respiratory infections including influenza.
Last winter though was carnage though particularly if you were a woman or aged 85 and over (See Excess Winter Deaths England and Wales)
If you combine the England, Wales and Scottish figures the number of excess UK winter deaths last winter was 54,879.
Sadly, our national disgrace continues and if anything things might slowly be getting worse after many years of improvement when the overall trend had been downwards since 2013-14 there has been a rising trend.
To give this more of a context in Scotland the +4,797 deaths considered to be excess was the largest number since winter 1999/2000. The +50,100 deaths in England and Wales was the highest recorded since winter 1975 to 1976.
Research released by the E3G group in February 2018 indicates not just why this happens but why this should be a source of national embarrassment. Iceland, Finland, Norway and Sweden all have fewer winter deaths per capita population than we do and there is little doubt that they are colder. To learn more and access the E3G group report CLICK HERE
I agree with the authors of the report that this preventable tragedy must end. It’s time for the UK Government’s (England Wales and Scotland) to get a move on and do something significant to provide the capital investment necessary to make many more UK’s homes warmer and safe for human habitation.
There are 759,000 adults carers in Scotland – 17% of the adult population and an estimated 29,000 young carers in Scotland – 4% of the under 16 population and without them the health and social care system would collapse. So I am asking you to support Carers UK’s campaign to increase Carer’s Allowance by at least £8.50, to match the changes being made in Scotland. Carer’s Allowance is the main benefit for carers and you can still get it even if you are working, so long as your earnings are no more than a weekly amount known as ‘the earnings limit’. The government has announced that the earnings limit will be going up to £123 per week from April 2019. While this should be good news for carers in low paid work, many of those on the National Living Wage (NLW) will not benefit. for more details see the post here at the CONTACT website
If you are looking after someone you might want to look at and download this handy guide for anyone caring for family or friends – it outlines your rights as a carer and gives an overview of the practical and financial support available:
Finally, on the same theme, a report from the Social Care Elf on a recently published paper called:
Sense of coherence and mental health of caregivers: a systematic review and meta-analysis
Which is about trying to identify early warning signs of psychological distress in carers.
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.
At the end of August, 10 charities published the findings of a shared workshop they had on the topic of incontinence which had taken place in December 2016. The resulting report which is called “My bladder and bowel own my life.” A collaborative workshop addressing the need for continence research” recommends tackling the stigma of incontinence and funding research into this often ignored issue. This new report describes the impact of continence issues on patients with long-term conditions and older people as discussed by the workshop participants and makes 8 clear recommendations for researchers, research funders, policy makers, commissioners and others in a position to make research into urinary and faecal continence problems more of a priority.
Research into urinary and faecal continence problems have been identified by patients, carers, family members and health and social care professionals as one of the key areas where further research is needed. This is because there are are a lot of areas in this field where further research could be done to improve the quality of life for people with a variety of conditions and circumstances, such as long-term neurological conditions and terminal illness. The 10 charities suggest that more research is needed into:
- the patient experience
- health economics
- clinical research into self-management techniques, co-morbidities, continence assessment and products, the impact of education, combined urinary and bowel continence research, side-effects and the interaction of medication prescribed for other long-term health conditions and their effect on incontinence symptoms.
- fundamental research to better understand bladder and bowel function
- the effect of non-surgical interventions.
Quite a knowledge gap, that needs to be tackled particularly since the NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence. Studies also suggest that in the UK “major faecal incontinence” affects 1.4% of the general population over 40 years old and that constipation affects between 3% and 15% of the population. It’s also widely believed that continence problems are under-reported so these figures could be quite a bit off as the numbers seeking treatment might be as low as 20% of those affected, which would mean around 15 million around a 1/5th of the UK population at any one time may be troubled by poor continence symptoms.
If you are affected by incontinence it is probably a good idea to be aware of NICE’s Topic Page on Urinary Incontinence and their Urinary incontinence in women interactive flowchart and to take some time to look at The Urology Foundation’s Urology Health Pages
In Scotland, the world’s biggest arts festival starts today. As always I’ll spend some time through there over the month and try and take in some shows/events etc. with my family.
So what might be worth seeing that focuses on Older People? Well, these aren’t my recommendations this list comes from Luminate, Scotland’s creative ageing organisation, which runs a diverse programme of creative events and activities throughout the year. So they know better than me what to see. So here is their list of recommendations.
What to See in Edinburgh 2018
I’m intrigued by one in particular… Who Do You Want to Wipe Your Bum?
Which features Dr Anna Schneider of Edinburgh Napier University highlighting a few things worth thinking about; considering you’ve got an 80% chance of needing care at the end of your life.
I suspect she will have to say something about this Global Health Workforce Labor Market Projections for 2030