Posts Tagged ‘Elderly Medicine’

Basic care given to elderly in hospital “alarming”

BBC Health - 13th October 2011 3:02 pm

Too many hospitals in England are falling short in the most basic care they are giving elderly patients, inspectors say.

The Care Quality Commission carried out unannounced visits at 100 hospitals to assess dignity and nutrition standards. It identified concerns in 55 cases, describing the findings as “alarming”.

Common areas of concern included a lack of support for those who needed help eating, poor hygiene and curtains not being closed properly.

Health Secretary Andrew Lansley said he would encourage whistle-blowers to highlight any concerns they had about the standard of hospital care for the elderly.

Read more at BBC Health.

Psychiatry: Anti-dementia drugs may help delay people’s admission to care homes

The Psychiatrist - 5th October 2011 10:15 am

Prescribing anti-dementia drugs to patients could help delay their admission to care homes, according to a new study published in the October issue of The Psychiatrist.

Psychiatrists Dr Emad Salib and Dr Jessica Thompson studied a total of 339 people with dementia, who were referred to psychiatric services in Peasley Cross Hospital in St Helens in 2006.

127 of the patients (24%) had been prescribed cholinesterase inhibitors. These drugs can help slow the progression of the disease by preventing an enzyme known as acetylcholinesterase from breaking down acetylcholine in the brain. Of the patients who were prescribed cholinesterase inhibitors, almost three-quarters (74%) were given donepezil (which is marketed under the trade name Aricept). A further 14% were given galantamine (trade name Reminyl), 8% rivastigmine (trade name Exelon), and 4% memantine (trade name Ebixa).

The remaining 212 patients in the study were not prescribed cholinesterase inhibitors. After four years, the researchers followed up all 339 patients to see if they had been placed in care or remained in their own home.

The researchers found that, on average, patients who did not take anti-dementia drugs moved to care homes sooner than patients who did. There was a delay in admission to care homes by a median of 12 months for patients who took anti-dementia drugs, compared to those who did not.

However, after three years, an equal proportion of patients from both treatment groups had been admitted to care homes. In other words, the delay in admission was relatively short-lived.

Hospital regulator raises elderly care concerns

BBC Health - 26th May 2011 12:03 pm

Serious concerns have been raised by the NHS care regulator about the way some hospitals in England look after elderly patients.

The Care Quality Commission said three had failed to meet legal standards for giving patients enough food and drink and treating them in a dignified way.

They were Alexandra Hospital, Redditch, the Royal Free, in London, and Ipswich.

The CQC, which carried out unannounced inspections, also raised concerns about three other NHS hospitals. The commission has published the first 12 results of 100 such inspections.

While its inspectors said there had been many examples of people being treated with respect and given excellent care, in other cases people had not been helped to eat and drink, “with their care needs not assessed and their dignity not respected”.

Read more at BBC Health.

Care of the elderly - the NHS can only do so much

By Katherine Teale - 21st February 2011 9:58 am

Damning, harrowing, disgraceful, shameful, shocking, inhumane and callous. The headline writers had a field day this week following the report by the NHS ombudsman Ann Abrahams, describing the care of ten elderly patients.

No one can deny that the care these individuals received was terrible. Perhaps an even more shocking fact is that I’m sure there is not one single doctor reading this who can’t call to mind at least one similar case.

Why, then, is it such a difficult nut to crack? Why, with all the extra resource which has been put into the NHS since 2000, is this still happening? Does it, as the government would have us believe, reflect an inherent problem with the NHS as an organisation?

“No” said Ray Tallis, arguing articulately on the Today programme. Elderly patients can receive equally terrible care in non-NHS institutions, for instance private nursing homes.

But it’s hardly a ringing endorsement of any organisation, and shows us at our very worst, with  everyone involved (nurses, doctors and managers) rushing to blame each other.

While individuals need to take responsibility for their own actions, we also need to look at wider causes. As a society, it is undeniable that we do not value old people. We worship youth - in fact the media is obsessed with it. Actors and  presenters (at least the female ones) are dropped at the first sight of a wrinkle. Old people are a nuisance, expensive, and not even nice to look at. They can’t get to grips with new technology, and struggle with mobile phones. Everything has to be explained - often several times, and they don‘t understand our jokes. They drive far too slowly, hogging the middle lane. There’s nothing glamorous about old age, especially when it’s poor, with bad teeth and dementia.

I remember once having a frank conversation with a group of medical students who were unimpressed with their placement on an elderly care ward because the patients, they complained, “take so long to give a history”. How boring and tedious examining an 80-year-old in chronic heart failure, when their friends were coming home with stories of articulate young patients on coronary care. So much quicker and more exciting.

Consider also how we regard people who do jobs which involve getting their hands dirty - whether that be cleaning, looking after elderly people, or mending cars. The further removed you are from the actual dirt, the more highly you are respected, and the more you get paid.

If we don’t respect or value those who care for elderly patients, is it so surprising that elderly patients are sometimes treated disrespectfully? Nor are  compassion and kindness encouraged in our modern world - you only have to watch an episode of Dragon’s Den or The Apprentice to see those qualities lose out every time to selfishness, greed and arrogance.

Perhaps a few of those newspapers which so quickly rushed to press, should seriously think about how they portray older people. Yes, the NHS must get its house in order - but it can’t cure all the ills of society.

Elderly patients’ harrowing plight revealed in report

The Guardian - 15th February 2011 11:41 am

The NHS is inflicting pain and suffering on elderly patients and ignoring their most basic needs, according to a report by the health service ombudsman which highlights cases where vulnerable patients were failed.

Some patients were not offered help with eating or bathing, and one was left in urine-soaked clothes held together with paper clips.

Older people too often did not receive the care, compassion and respect they deserved, according to the ombudsman, Ann Abraham.

Her report cites 10 cases inadequately investigated by the NHS, in which elderly men and women were treated appallingly, often towards the end of their lives. It details serious failings in how NHS staff managed the patients’ pain, nutritional needs and discharge from hospital, often with disastrous consequences.

Her disclosures led to calls for the NHS to urgently overhaul its care of the elderly.

Read more in The Guardian.