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Showing results for tags 'Older People (over 65)'.
Found 272 results
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Content ArticleThis paper from Natalie Offord and colleagues describes a service redesign in which has gained learning and experience in two areas. First, a description of measured improvement by the innovation of redesigning the traditional hospital-based assessment of frail older patients’ home support needs (assess to discharge) into their own home and meeting those needs in real time (discharge to assess). In combination with the formation of a collaborative health and social care community team to deliver this new process, there has been a reduction in the length of stay from completion of acute hospital care to getting home (from 5.5 days to 1.2 days for those patients that require support at home). Second, the methodology through which this has been achieved. The authors describe their translation of a Toyota methodology used for the design of complex cars to use for engaging staff and patients in the design of a healthcare process.
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Content ArticleThe NHS saved William Fear's life and inspired him to change career. But when William started as a healthcare assistant on a hospital ward for older patients, it was clear how bad things had got. This is his story, told to the Guardian, of a typical shift
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Content ArticleIn the UK, the focus of osteoporosis care in the NHS has been on people who have sustained a fragility fracture as a result of their underlying condition. Not much has been done to try and prevent the first fracture by promoting good bone health and proactively identifying people at higher risk. This report by the APPG on Osteoporosis and Bone Health presents the results of its inquiry into primary care provision for people with osteoporosis and those at high risk of fracture, launched in March 2022. The inquiry aimed to establish the current quality of care being offered to patients.
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News Article
93-year-old left ‘screaming in pain’ on floor during 25-hour ambulance wait
Patient Safety Learning posted a news article in News
The Welsh ambulance service has apologised after a 93-year-old woman was left “screaming in pain” while lying on the floor with a broken hip during a 25-hour ambulance wait. Elizabeth Davies fell at her care home on Saturday and was finally picked up at 1.15pm on Sunday and admitted to Ysbyty Gwynedd hospital in Bangor on Monday, where she endured another 12-hour wait before being admitted to a ward. A hip fracture was later confirmed in surgery. Her family have said the incident, which occurred before a 24-hour strike on Wednesday by ambulance workers, was “unacceptable”. Her son, Ian Davies, from Pwllheli, said: “It was very upsetting to have to see her lying on the floor screaming in pain for over 24 hours.” After her injury, staff at the care home, where Davies has lived for 17 years, are understood to have propped a pillow under her head and tried to make her comfortable on the wooden floor, using a small heater to keep her warm in case she went into shock, as well as providing an absorbent pad so she could urinate. Her son, a community care worker, said: “They called for an ambulance but were advised an ambulance wouldn’t be available for six to eight hours as they were so busy. “They said my mother would be a priority because of her age. The care home then called us and we came immediately. “I don’t blame the ambulance staff because they are told what jobs to do and my mother wasn’t on the list.” It is understood the care home made nine calls, with a 10th made by Ian Davies. Read full story Source: The Guardian, 20 December 2022 -
Content ArticleFor decades, western Europe’s national healthcare systems have been widely touted as among the best in the world. But an ageing population, more long-term illnesses, a continuing recruitment and retainment crisis plus post-Covid exhaustion have combined, this winter, to create a perfect healthcare storm that is likely to get worse before it gets better, writes Jon Henley (Berlin), Kate Connolly (Berlin), Sam Jones (Madrid) and Angela Giuffrida (Rome) in this Guardian article.
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News Article
Good social relations promote active and healthy aging in Europe, finds researcher
Clive Flashman posted a news article in News
In the older European population, men, as well as those with lower socioeconomic status, weak social ties, and poor health, might experience more difficulties getting informal support and are considered to have a higher risk of worsening frailty state and lower quality of life. This reality is shown in a new doctoral thesis at Umeå university. Read the full article here -
News Article
My mum's 40-hour wait to get to A&E with hip break
Patient Safety Learning posted a news article in News
When 85-year-old Koulla fell at home, her family immediately rang for an ambulance. She was in agonising pain - she had broken her hip. It was around 8pm. It took another 14 hours for an ambulance to get to her, leaving her pregnant granddaughter to care for her through the night. When they arrived the crews were able to give her pain relief and quickly transported her to the Royal Cornwall Hospital. But there the wait continued - there were around 30 ambulances queuing to handover patients to A&E staff. It was another 26 hours before she was taken inside to A&E. She then faced many hours in A&E before being taken for surgery. Koulla's daughter, Marianna Flint, 53, said: "It was awful. You feel helpless because you're giving your trust over to them to look after a family member who's in agony and who needs surgery." She has since received a written apology from the Royal Cornwall for the care provided to her mother in August. Ms Flint said: "I almost feel sorry for those looking after her. It's not down to them. There was no room inside to accept her in." Read full story Source: BBC News, 1 December 2022 -
News Article
Midnight discharge at Colchester Hospital unacceptable says family
Patient Safety Learning posted a news article in News
Lack of beds in the NHS and social care sector have been highlighted by the case of an 81-year-old woman discharged home at night, her family said. Janice Field attended Colchester Hospital in Essex with a suspected heart attack. She was returned to her flat at midnight, despite having no home care at that time of day. The hospital trust said it focused on keeping patients safe and was "sorry to hear about the concerns raised". Ms Field was checked out at the hospital last week and deemed fit to go home, but her family said she should have stayed in hospital overnight, or be found a community care bed. Her daughter-in-law, Sarah Field, a qualified nurse, said: "To discharge an 81-year-old lady and have them having to be transferred in the middle of the night is totally unacceptable. "But the nurse we spoke to was emphatic. She was desperate. She said, 'no, we have no beds. This has got to happen. She's clinically fit. She has got to go'. "The NHS is broken, under-resourced and not fit for purpose. This is not the fault of those that work in it, but the fault of the system." Read full story Source: BBC News, 26 November 2022 -
News Article
Devon carer who murdered woman had violent crime history
Patient Safety Learning posted a news article in News
A carer who murdered the elderly woman he was employed to look after had a history of violent crime including actual bodily harm, a report found. A safeguarding adults review over the death of a 77-year-old Devon woman in 2021 criticised working practices among organisations involved in her care. Devon and Cornwall Police did not disclose information about domestic abuse callouts involving the killer in a DBS check by the care provider. He was jailed for life in July 2022. The woman had seen her killer as "a grandson" figure, it said. The 35-year-old killer attacked his victim after she discovered he had stolen several thousand pounds from her. The had no previous employment experience of care before being taken on as her sole carer by Complete Quality Care Ltd, an independent care provider. Read full story Source: BBC News, 24 November 2022 -
Content ArticleMedications and specifically fall-risk-increasing drugs (FRIDs) are associated with increased risk of falls: reducing their prescription may improve this risk. This study from Cox et al. explored patient characteristics associated with FRID use, prevalence and type of FRIDs and changes in their prescriptions among older people with arm fractures over 6 months. The study found that more than one FRID prescription had a significantly higher number of co-morbidities and medications and higher rates of male gender, polypharmacy, frailty and sarcopenia. The most frequently prescribed FRIDs were antihypertensives, opioids and antidepressants. Use of FRIDs among older people with upper limb fragility fractures was high. Although overall use decreased over time, 59% were still on 1 or more FRID at the 6-month follow-up, with trends to stop opioids and start antidepressants. Older people presenting with upper limb fractures should be offered a structured medication review to identify FRIDs for targeted deprescribing.
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Content ArticleThe National Audit of Inpatient Falls (NAIF) has published its latest report into the care given to patients who fell while they were in hospital and sustained a hip fracture. Based on data from 1,394 patients in 2021, the report presents information on post-fall management and tracks performance against National Institute for Health and Care Excellence (NICE) Quality Standard 86, which includes checking the patient for injury before moving, using safe lifting equipment and prompt medical assessment after the fall.
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News Article
Top doctor ‘desperate’ to keep parents out of ‘lobster trap’ hospitals
Patient Safety Learning posted a news article in News
One of the country’s most senior doctors has said he is “desperate” to keep his elderly parents out of hospital, which he said are like “lobster traps”. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said hospitals are easy to get into but hard to get out of. His comments come after figures showed the number of patients in hospital beds in England who no longer need to be there has reached a new monthly high. An average of 13,613 beds per day were occupied by people ready to be discharged from hospital in October. That was up from 13,305 in September and the highest monthly figure since comparable data began in December 2021, according to analysis by the PA news agency. In an interview with the Daily Mail, Dr Boyle said: “Hospitals are like lobster traps – they’re easy to get into and hard to get out of. “If social care was able to do its job in the way we want it to, these poor people wouldn’t be stranded in hospital. “I have elderly parents and I’m desperate to keep them out of hospital. “For someone who is frail, hospital is often a bad place for them. They’re being harmed by being in hospital.” Read full story Source: The Independent, 14 November 2022 -
Content ArticleSafety conversations are an important step in building a proactive patient safety culture. They’re a respectful discussion about safety between two or more people involved in organising, delivering, and seeking or receiving care. This collection of tools and resources, from quick tip sheets to comprehensive reports and frameworks, aims to help healthcare professionals to have effective safety conversations and support safer care of older adults.
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News Article
NHSE investigates concerns over-65s have received ineffective flu jab
Patient Safety Learning posted a news article in News
NHS England is investigating a “potential serious incident” in its flu programme following concerns that people aged 65 and over are being given a vaccination jab known to be ineffective for this age group. Details of the investigation were set out in a letter by NHS England’s South East regional team. The letter, seen by HSJ, said: “The NHS regional direct commissioning team are investigating reported administration of QIVe flu vaccine to patients aged 65 years or older by a number of primary care providers (primary care and pharmacy) across the region. QIVe is not recommended for use in this age group due to its poor effectiveness.” It said officials were contacting practices and pharmacists directly where there was a record of QIVe vaccine having been given to the older age cohort to identify whether this is a recording coding error, or a genuine administration of QIVe. Initial investigations “suggest a mixture of both”, it said. The letter added: “If any patient 65 or over has received QIVe, we will be asking the practice or pharmacist to treat this as an incident. Patients will need to be contacted, informed of the error, its potential implications and offered the opportunity to receive a vaccine which is appropriate for their age group." It is unclear how many patients have been given the wrong jab. Read full story Source: HSJ, 8 November 2022 -
News Article
Can interim care help ease Scotland's hospital bed shortage?
Patient Safety Learning posted a news article in News
Many people who are medically ready to leave hospital are not able to go home because of pressures in social care. Health and social care teams across Scotland are working to create more room in hospitals as we go into winter when it traditionally gets busier. In Lothian, they are using care homes as an interim measure to help rehabilitate people before they can go back home. Nineteen rooms at the Elsie Inglis Nursing Home in Edinburgh are being used in an effort to help people get out of hospital. Archie McQuater, who spent seven months in The Royal Infirmary of Edinburgh after one of his big toes was removed because of an infection, has finally got out of hospital and is now staying at the Elsie Inglis. The 94-year-old has been in the care home for two months and is trying to improve his mobility so that he can return home. Archie is among 200 people in Edinburgh who have been moved from a hospital to a care home between November 2021 and September 2022. NHS Lothian estimates it has saved about 13,000 bed days in hospitals during that time. Read full story Source: BBC News, 2 November 2022 -
Content ArticleWe need urgent radical solutions for the crisis in social care, to prevent the collapse not just of the NHS but of the entire UK economy. Social care is facing extreme difficulties with funding and workforce shortages. Staff are poorly paid, and 10% of posts are vacant. The situation is about to get worse: 19% of the UK population is over 65. In Northern Ireland the number of people over 65 more than doubled between the censuses in 2011 and 2021. Projections show that each person will need an average of 10 years of social care. We must, then, focus on prevention. The need for social care is not inevitable. Ageing does not have to be associated with a loss of fitness. Exercise and strength training can restore muscle and balance and are proved to reduce the impact of falls and fractures.
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News Article
NHS boss Amanda Pritchard vows that victims of falls won’t wait hours in agony
Patient Safety Learning posted a news article in News
Elderly people who call for help after a fall at home will no longer be left waiting for hours on the floor, the head of the NHS has said, as she bids to keep patients out of hospital and stop the service being overwhelmed this winter. Amanda Pritchard said she would start a new national service within weeks under which community teams would offer immediate help to people who had had an accident but had avoided serious injury. Pritchard, who took over as chief executive of NHS England last year, said a quarter of less severe 999 calls in January involved falls. The new teams could stop 55,000 elderly people a year being taken to hospital, she said. All NHS areas will be told this week to establish the service before a “very, very, very challenging winter” for the health service. Read full story (paywalled) Source: The Times, 16 October 2022 -
News Article
Secret footage reveals abuse of woman with dementia at luxury UK care home
Patient Safety Learning posted a news article in News
An 88-year-old woman with dementia was physically and mentally abused at a luxury care home charging residents close to £100,000 a year, the Guardian can reveal. Staff misconduct was exposed by secret filming inside the home run by Signature Senior Lifestyle, which operates 36 luxury facilities mostly in the south of England. It has admitted that Ann King was mistreated at Reigate Grange in Surrey earlier this year. Distressing footage from a covert camera inside her room shows: Care staff handling King roughly, causing her to cry out in distress. On one occasion she was left on the floor for 50 minutes. King being taunted, mocked and sworn at when she was confused and frightened. The retired nurse being assaulted by a cleaner, who hits her with a rag used to clean a toilet while she is lying in bed. The cleaner threatening to empty a bin on the pensioner’s head and making indecent sexual gestures in her face. The abuse was exposed by King’s children, Richard Last and Clare Miller. They became so concerned about her wellbeing at the care home, where she lived from January 2021 to March 2022, that they installed a hidden camera on her bedside table. They have shared the footage because they fear what happened to their mother may not be an isolated incident, and because: “She has always been horrified by this type of thing and we felt she would have wanted us to show this is going on.” Read full story Source: The Guardian, 13 October 2022 -
News Article
Social care: 'Jo's care will cost £1.5k a week - the system is broken'
Patient Safety Learning posted a news article in News
It was only a year ago that Boris Johnson stood up in Parliament and said he was going to fix the long-term problems in social care. He announced a new tax - to raise about £12bn a year - would be spent on health and social care costs only. But the UK's new prime minister, Liz Truss, has already scrapped the plan. Families, carers and care providers have been left asking where the funding will now come from to fix a system, which they say is broken. Dr Jo Wilson was a high-flying international executive before she was diagnosed with dementia two years ago, aged 66. Her husband, Bill, insists he's her husband, not her carer. But he now sees to Jo's every need. Bill has had to find fight and persistence to navigate the world of dementia care. "It took me two years to get a care package in place for Jo," he explains. "And I only got that because Jo had a collapse at home and was taken into hospital." Even after it was confirmed Jo could have carers come to their home to help, Bill found the variety of staff, unreliable time keeping, and a lack of understanding of dementia, left him questioning whether it was worth it. He's now permanently exhausted, and frustrated. Professor Martin Green, chief executive of Care England, says without a complete restructure of the social care system "thousands, if not millions, will be left without support, and the NHS will be on its knees". It is a warning heeded by others. A new poll by Ipsos Mori for BBC News, suggests more than 70% of those over 55 are not confident that social care services will provide care to those in need. More than half of responses cited staff shortages and limited public funding as their main concerns. Care providers say it's these issues that are putting them under extreme pressure. "We know currently that three in five people with dementia do not get the support that they need once they have that diagnosis. And that leads to crisis in care", says Fiona Carragher, director of policy at the Alzheimer's Society." Read full story Source: BBC News, 7 October 2022 -
Content ArticleA broken hip or ‘hip fracture’ is a serious injury, which each year in the UK leads to around 75,000 people needing hospital admission, surgery and anaesthesia, followed by weeks of rehabilitation in hospital and the community. The National Hip Fracture Database (NHFD) is an online platform that uses real-time data to drive Quality Improvement (QI) across all 163 hospitals that look after patients with hip fractures in England and Wales. This report highlights key research carried out using data from the NHFD in 2021, and makes a number of recommendations to improve treatment and outcomes for patients with hip fractures.
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News Article
People with recent dementia diagnosis found to have higher suicide risk
Patient Safety Learning posted a news article in News
People who have recently been diagnosed with dementia, or who are diagnosed with the condition at a younger age, are among those at increased risk of suicide, researchers have found. The findings have prompted calls for greater support for those experiencing such cognitive decline. While previous research has explored a potential link between dementia diagnosis and suicide risk, the results have been inconclusive, with some suggesting a raised risk and others a reduced risk. Now researchers say certain groups of people with dementia are at increased risk of suicide. “What it tells us is that period immediately after diagnosis is when people really need support from the services that provide the diagnosis,” said Dr Charles Marshall, co-author of the research and a clinical senior lecturer and honorary consultant neurologist at the Wolfson Institute of Population Health at Queen Mary University of London. In the first three months after being told they had dementia, those diagnosed before the age of 65 had an almost seven times greater risk of suicide compared with those without dementia – although this reduced somewhat over time. Marshall said it was unclear whether the findings were down to dementia itself causing people to feel suicidal, or factors such as people being concerned they may become a burden to their family. Read full story Source: The Guardian, 3 October 2022 -
News Article
Paramedics pilot plan to reduce huge ambulance queues at A&E
Patient Safety Learning posted a news article in News
Hannah Rusby reassures her patient he’s in good hands. He is in his eighties, skeletal, confused and struggling to answer basic questions. His breathing is rapid. After a few minutes of probing questions and basic tests, Rusby knows this is serious — after months of decline while living alone, the man is critically ill and needs to go to hospital urgently. With more than 500,000 people waiting for social care assessments across England, emergency calls such as this are increasingly common. “We are becoming a middleman for all the other services,” said Rusby, who qualified as a paramedic seven years ago and works for the London Ambulance Service (LAS). She said the job increasingly involves responding to people who fall through society’s cracks. Daniel Elkeles, 49, chief executive of the LAS, agrees: “There are lots of patients who, if something else were available, we wouldn’t need to take them to hospital. As the population has got older and frailer, it’s unsurprising that an increasing number of the calls are not traditional emergencies.” He believes paramedics can be the link between GPs, community nursing and social care. From next week, the LAS will pilot having three cars covering six boroughs in southwest London. Each will have a paramedic and a community nurse and will respond to 999 calls from elderly people who have fallen at home. They’re going to see every frail elderly person who has fallen [and] hasn’t broken a bone, and our aim is to keep all of those patients at home. The community nurse will assess the house to make sure it’s safe then refer the patient to their GP and an urgent community response team,” said Elkeles. The service hopes this will mean as many as 1,000 fewer people going to A&E a year. Read full story (paywalled) Source: Sunday Times, 2 September 2022 -
Content ArticleThis article tells the story of Mr K, who died following a misdiagnosis of tension pneumothorax. Mr K was 81 and had a history of chronic obstructive pulmonary disease (COPD) and bullous emphysema. He had been diagnosed with a bulla, a large air pocket, in his right lung. The medical team treating Mr K after his admission to hospital with shortness of breath failed to review his previous x-ray and medical notes, and did not involve the respiratory team in his treatment. This led to his misdiagnosis, after which he was fitted with an unnecessary chest drain. The drain collapsed the bulla and ruptured a blood vessel leading to progressive bleeding. The medical team did not recognise their error or Mr K's bleeding and he died two days following the insertion of the drain. At his inquest, the Coroner found that the unnecessary chest drain led to Mr K's death, and that there was a missed opportunity to reassess the situation at a review the next day. They ordered that a prevention of future death report be made as the evidence heard at the inquest revealed a number of matters that gave rise to concern.
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Content ArticleRichard von Abendorff's elderly mother died an avoidable, painful death in hospital due to being inappropriately prescribed Nalaxone. In this article, Richard outlines the steps he has taken to try and ensure lessons are learned from his mother's experience. Eventually, in 2014 NHS England published a patient safety alert relating to inappropriate doses of naloxone in patients on long-term opioid treatment. A coroner’s palliative expert report identified issues contributing to Richard's mother's poor end of life care, noting that purely advisory palliative services in an acute hospital setting are ‘not fit for purpose’ to meet the needs of more complex dying patients. Richard expresses his frustration at an ongoing lack of interest and action related to substandard end of life care.
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Content ArticleThe National Institute for Health and Care Excellence (NICE) is developing an update to the guideline on assessment and prevention of falls in older people and people 50 and over at higher risk. It has published the final scope for the update alongside consultation comments and responses, an equality impact assessment and the stakeholder list. The final guidance is expected to be published on 13 June 2024.
