Is Health and Social Care in Safe Hands?

Ever wondered how the Care System works across the UK. Well here is a handy and new guide from the BBC: http://www.bbc.co.uk/news/health-30902552

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Now is it actually working? Yesterday saw the publication of a new report investigating the state of social care  through the eyes of individuals and families(in England and Wales particularly). It  reveals a system struggling to cope.   Where:

  • people have difficulties accessing high-quality care
  • there is a lack of support for family carers
  • care packages that are not personalised
  • there are serious doubts about the sustainability of the social care provider market
  • there remains a need for a high-quality, trained and motivated workforce that can provide continuity of care.
  • the continued failure to integrate health and social care is leaving older people trapped in hospital beds.

The Real Lives report, published by the Richmond Group of Charities in partnership with the British Red Cross and the Royal Voluntary Society, sets out the real life experience of seven individuals and families using social care services today.You can download the report here:Real Lives Report 2016

This report is a companion piece to a major report, on “Social Care for Older People: Home Truths”, also published yesterday by the King’s Fund and Nuffield Trust. To read more about this report and download a copy go to:

http://www.kingsfund.org.uk/publications/social-care-older-people

They don’t make for very pleasant reading but the time for government and everyone else  to act is now.

This is also a good opportunity to draw your attention to the latest Age UK Campaign which is about the threat to change the rules around the provision of Attendance Allowance. Attendance Allowance in the UK is a weekly payment that helps older disabled people meet some of the extra costs they face. It’s a vital means of support that assists hundreds of thousands of older people to stay independent in their own homes. It is currently threatened by plans to devolve responsibility for payments to local councils which will mean as always different rules in different areas depending on the financial state of  your council’s budgets

To voice your concern about this and finds out more , go the link to Age UK’s “Help protect Attendance Allowance Campaign” which is given below

http://www.ageuk.org.uk/get-involved/campaign/attendance-allowance-campaign/

 

 

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Dementia MOOC and Discharging Older People

Since its still World Alzheimers Month, I’ll start by looking at Dementia. There is a great Dementia Massive Open Online Course (MOOC) that you can join this month which is run by the Wicking Dementia Research and Education Centre at the University of Tasmania. This MOOC is one of the best known in this field and if you know anyone who is a carer of someone with a dementia or you would like to know more yourself the MOOC is still enrolling up until  23rd September 2016, 5:00pm Australian Eastern Standard Time (AEST). That’s 7am. GMT (they are 10 hours ahead). To enrol go to:

http://www.utas.edu.au/wicking/understanding-dementia

Something else that’s quite interesting that I came across this week are new ‘home from hospital’rooms for patients with dementia that have been designed by nurses. The new rooms were created for Pinderfields Hospital, near Wakefield , in Mid Yorkshire in the UK and are designed to provide a dignified and compassionate environment for people who need extra support from their loved ones. You can have a look at the rooms on line at:

 

On the day that NHS England revealed that its hospitals are facing record levels of delays in discharging patients. See: http://www.bbc.co.uk/news/health-37307853

It is worth considering why this might be the case. Some insight into this issue is provided by a recent National Audit Office (NAO) Report looking at Discharging Older People from Hospital. Back in May they published a detailed report that highlighted that although hospitals are financially incentivised to reduce discharge delays, there were no similar incentives for community health and local authorities to speed up receiving patients discharged from hospital amongst other things. You can download a summary of the NAO findings at:

https://www.nao.org.uk/report/discharging-older-patients-from-hospital/

It’s World Alzheimer’s Month

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For those of you who aren’t familiar with older people’s care issues September is always World Alzheimer’s Month, so don’t be too surprised if my posts this month are all focused on different aspects of Dementia because quite a lot of new material appears at this time. So I’ll start with the obvious. The Alzheimer’s International World Alzheimer’s Month Page has opened and they have a great video and infographic that you can view and share and a number of other resources that you can use to spread the word. Go to World Alzheimer’s Month to take a look at and use their resources.

Later in the month the latest World Alzheimer Report 2016 will be launched by Alzheimer’s Disease International (ADI) in partnership with King’s College London and London School of Economics on the 20 September 2016. The following day, i.e. 21 September is World Alzheimer’s Day so expect more to be  published via the ADI website.

Its also worth noting that  World Suicide Prevention Day is a bit closer as it is on the 10 September, 2016. Again this day has its own website which is run by the organisation , the International Association for Suicide Prevention (IASP), which is supported by WHO. The resources and information to support this day are available at:

https://www.iasp.info/wspd/

Suicide amongst older people is a frequently over looked problem because of the high incidence in young men, but to get a good idea of how serious and relevant is in older people’s care there is a free to access Royal College of Psychiatrist’s Literature review from 2015 available at: http://www.rcpsych.ac.uk/pdf/Jane%20Leadbetter-%20Depressive%20disorder%20and%20suicide%20in%20the%20ol%C3%94%C3%87%C2%AA.pdf 

Perhaps its time to raise more people’s awareness of this terrible risk.

A Revolution in Treating Depression.

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A really interesting development was discussed on the BBC this week that concerns depression. In the UK, it is believed that one in four older people have symptoms of depression that require treatment, and that fewer than one in six older people with depression discuss their symptoms with their GP. Out of this group, only half receive adequate treatment. This is really important because untreated depression is the leading cause of suicide among older people, with men living alone at particularly high risk (Royal College of GP’s,  2011). So any new developments in this field have the potential not only to improve the lives of older people, but can actually save lives!

As the BBC  report, it’s not very often we get to talk about a revolution in understanding and treating depression and yet now doctors are talking about new work, some of which is taking in place in Glasgow being one of the strongest discoveries in psychiatry for the last 20 years.

The focus of this new line of enquiry is on the idea that an errant immune system causing inflammation in the body, is altering mood sufficiently to trigger clinical depression. If you consider the last time you had a cold, you will appreciate that there is probably a link, but this is taking that thought a big step further.

For more information about this work you can read about it at

http://www.bbc.co.uk/news/health-37166293

Another way to find out more is to listen to the BBC Radio 4 documentary “The Inflamed Mind” which you can catch at

http://www.bbc.co.uk/programmes/b07pj2pw

If you want to know a bit more about Depression in Older Adults, there is a really useful  introductory leaflet available at:

http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/depressioninolderadults.aspx

Having Difficult Conversations

Last month saw the publication of a new report by the charity Independent Age which summarises research looking at how and why families avoid talking about the challenges they may face in older age. The report is called “We need to talk about caring: dealing with difficult conversations” and can be downloaded from here:

 

difficult conversations

https://www.independentage.org/policy-research/research-reports/we-need-to-talk-about-caring-dealing-difficult-conversations

It draws on an online poll of 2,066 people conducted by ComRes and a series of focus groups and interviews. This work indicates that while four out of five people agree that it’s important to discuss key topics like housing and care in old age, less than a third of British adults have ever had a conversation of this kind with a family member. The picture doesn’t improve as people get older and these issues become more real – almost two thirds of those aged 65 and over have never had aconversation with family members about these key topics. That’s around 7 million older people and their families uncertain about how they’d manage if they needed care and support in older age. Exploring the reasons behind these missed conversations using focus groups, older people and their families told us that:

  • They often lacked knowledge and confidence to begin a conversation and were anxious they might suggest the wrong thing
  • They wanted to avoid thinking about scenarios that might threaten future independence such as needing to leave your home
  • They wanted to protect family members from worry or upset
  • The timing never seemed right and they felt it was better to wait until an event or trigger made the conversation unavoidable
  • Distance and a lack of time together could also act as a barrier

So what can we do to encourage people to sit down and have these difficult conversations. Alongside their research the charity have also launched an online resource for families whowant to talk to older relatives about sensitive issues. It gives some suggestions for how to begin conversations and specific information on five key areas that they  think families should consider talking about. The guide can be found at Difficult Conversations Guide

So now that I have raised the issue; have you had this kind of conversation with your loved ones?  Maybe now is the time. 

The Power of the Arts; Theatre and Images

Its that time of year; its cold, its wet and its windy (at least this week it has been), so it must be Edinburgh Festival time! So if you are going to Edinburgh at all this week here is a recommendation. You could try and see a play called “Finding Joy” . Its on between Aug 4 – Aug 14 at  16:30 at the Assembly Hall in the appropriately named Rainy Hall. 

Finding Joy explores the life of Joy, who is a woman who has a playful spirit, a love of dancing, and dementia. Joy lives with her daughter and grandson, Danny . The play is actually based on the true story of Danny, a young man who uses unorthodox methods to care for his Grandmother. Finding Joy has been touring the country, with Edinburgh apparently being the last leg, so you will need to be fast to see it. Hopefully it will tour again if it is a success. 

Here is a short clip and a warning that if you go along, hankies may be required.

https://vimeo.com/165610848

Age International this week announced the winners of their ‘Strength For Life’ photographic competition. The images are quite captivating along with the stories of the people that they portray but sadly the exhibition is only being shown in London. The winning  photos will go on display alongside images taken by The Guardian’s David Levene, during October. If you want to have a look at some of them go to:  http://www.ageinternational.org.uk/latest-news/winner-of-the-strength-for-life-photo-competition/

If you liked these, you might also like the work  being done by Eva de Vries’s called “The Wise People Project”. Eva is a a Dutch freelance journalist and storyteller and since March 2016 has been based in East Africa. In this project she takes portraits of older men and women and explores their stories and her first set of images and stories are really powerful. See: http://storiesbyeva.com/multimedia-projects/the-wise-people-project/

Worth keeping an eye on I think.

Tackling Domestic Abuse and Don’t Forget Kate.

This week I want to draw your attention to Charity called Safe Lives. Safe lives is a national charity dedicated to ending domestic abuse. Previously called Co-ordinated Action Against Domestic Abuse (Caada). Their experts set out to find out what works to stop domestic abuse. It claims to have a really high success rate in  what it does stating that after getting the right help, more than 60% of victims tell the charity that the abuse has. stopped

Throughout July and August, they have decided to focus upon Older People and domestic abuse they are releasing the latest research and practical resources for professionals working with older people. To give you an idea of the scale of this problem this Safe Lives Infografic has been published and is reproduced here:

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For more details about what they are doing and to access more resources visit: http://www.safelives.org.uk/node/861

I also want to mention the sad news of the death of Kate Granger, who died on Saturday 23rd July 2016 from a rare sarcoma.If you have never heard of her, Kate was the person largely responsible for re-affirming the idea that every encounter with a person attending an NHS service should begin with the words “Hello my name is …”.  So every morning when you put on that “hello my name is” badge, it is Kate Granger’s efforts that you are acknowledging. To find out more about her, and the campaign she started got to http://hellomynameis.org.uk/

I personally think its a great tragedy that such a campaign was ever needed as healthcare professionals are all taught the importance of good communication. It just goes to show that what is taught can just as easily be unlearned or forgotten, if it does not become a habit.  However, as both a patient and doctor her observations and those of so many other people required a response and introductions, as she rightly points out are the first rung on the ladder to providing truly person-centred, compassionate care; something that has my full support. An interesting section of the site gives some of the evidence behind the importance of introductions to view this go to: http://hellomynameis.org.uk/evidence