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News ArticleThe government is facing criticism over its guidance on safe visits to care homes in England. Labour and a number of charities have described the suggestions, including floor-to-ceiling screens, designated visitor pods and window visits, as impractical. Alzheimer's Society has said it "completely misses the point". Justice Secretary Robert Buckland told BBC Radio 4's Today programme the guidance was "non-exhaustive". The updated government advice, which came into effect on Thursday, says care homes - especially those which have not allowed visits since March - "will be encouraged and supported to provide safe visiting opportunities". Labour's shadow care minister Liz Kendall said many care homes would not be able to comply with the government's requirements which meant "in reality thousands of families are likely to be banned from visiting their loved ones". She said instead of suggesting measures such as screens, the government should "designate a single family member as a key worker - making them a priority for weekly testing and proper PPE". Kate Lee, chief executive at Alzheimer's Society, said: "We're devastated by today's new care home visitor guidance - it completely misses the point: this attempt to protect people will kill them." She said the pandemic had left people with dementia isolated and thousands had died. The guidelines "completely ignore the vital role of family carers in providing the care for their loved ones with dementia that no one else can", she added. She said the "prison-style screens" proposed by the government with people speaking through phones were "frankly ridiculous when you consider someone with advanced dementia can often be bed-bound and struggling to speak". That view was echoed by Caroline Abrahams, charity director at Age UK, who said she was "acutely aware" that the methods being sanctioned were "unlikely to be useable by many older people with dementia, or indeed sensory loss". Read full story Source: BBC News, 5 November 2020
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Content ArticleElderly people in care homes in Cornwall were abused and neglected while failings led to reports of concerns not being investigated, a new Safeguarding Adults Review has found. The Morleigh Group, which operated seven homes in Cornwall and has since shut down, was exposed in a BBC Panorama investigation in 2016. A new Safeguarding Adults Review which was commissioned as a result of the TV show has been published making a number of recommendations to all agencies which were involved in the case. The review was completed in April 2019 but has only just been made public - Rob Rotchell, Cornwall Council Cabinet member for adult social care said that this was due to the number of agencies being involved.
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Content ArticleThe Cornwall and Isles of Scilly Safeguarding Adults Review into The Morleigh Group has found elderly people in care homes in Cornwall were abused and neglected while failings led to reports of concerns not being investigated. The Morleigh Group operated seven homes in Cornwall and has since shut down. The review was completed in April 2019 but has only just been made public - Rob Rotchell, Cornwall Council Cabinet member for adult social care said that this was due to the number of agencies being involved.
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News ArticleNHS bosses have denied claims that thousands of frail elderly people were denied potentially life-saving care at the peak of the pandemic in order to stop the health service being overrun. NHS England took the unusual step on Sunday of issuing a 12-page rebuttal to allegations in the Sunday Times that patients deemed unlikely to survive were “written off” by being refused intensive care. Prof Stephen Powis, NHS England’s national medical director, said: “These untrue claims will be deeply offensive to NHS doctors, nurses, therapists and paramedics, who have together cared for more than 110,000 severely ill hospitalised Covid-19 patients during the first wave of the pandemic, as they continue to do today." “The Sunday Times’ assertions are simply not borne out by the facts. It was older patients who disproportionately received NHS care. Over two-thirds of our COVID-19 inpatients were aged over 65. “The NHS repeatedly instructed staff that no patient who could benefit from treatment should be denied it and, thanks to people following government guidance, even at the height of the pandemic there was no shortage of ventilators and intensive care.” The newspaper claimed the high coronavirus infection rate in the UK before lockdown began on 23 March and the NHS’s limited supply of mechanical ventilators going into the pandemic meant that “the government, the NHS and many doctors were forced into taking controversial decisions – choosing which lives to save, which patients to treat and who to prioritise – in order to protect hospitals”. The Sunday Times said its claims were the result of a three-month investigation that involved speaking to more than 50 sources in the NHS and the government about the health service’s response to the pandemic. Read full story Source: The Guardian, 25 October 2020
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News Articlen the day Boris Johnson was admitted to hospital with COVID-19, Vivien Morrison received a phone call from a doctor at East Surrey Hospital in Redhill. Stricken by the virus, her father, Raymond Austin, had taken a decisive turn for the worse. The spritely grandfather, who still worked as a computer analyst at the age of 82, was not expected to survive the day. His oxygen levels had fallen to 70% rather than the normally healthy levels of at least 94%. Vivien says she was told by the doctor that her father would not be given intensive care treatment or mechanical ventilation because he “ticked too many boxes” under the guidelines the hospital was using. While ministers delayed lockdown, soaring cases were putting immense pressure on hospitals. This investigation from The Times shows officials devised a brutal ‘triage tool’ to keep the elderly and frail away. Read full story (paywalled) Source: The Sunday Times, 25 October 2020)
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Content ArticleAn open letter has been published in the Nursing Times from infection prevention and control experts, together with interested and concerned individuals and organisations, about the restrictions enforced in nursing, care and residential homes. Restrictions are being imposed in relation to COVID-19 across too many nursing, care and residential homes in the UK and beyond, in the name of infection prevention and control. A number of experts in this field, led by Jules Storr, independent global health consultant and former Infection Prevention Society (IPS) president, summarise in an open letter why infection prevention and control should be an enabler not a barrier to safe, compassionate human interaction in nursing, care and residential homes. By adding their voice their intention is to accelerate action to end this uncompassionate treatment of people in homes as well as for their families and other loved ones.
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Content ArticlePublished by the Older People's Commissioner for Wales, Care Home Voices: A snapshot of life in care homes in Wales during Covid-19, gives a voice to people living and working in Welsh care homes and provides a snapshot of their experiences during the COVID-19 pandemic. The responses from older people and their families and friends highlight just how difficult lockdown has been for many people. Many older people had not seen their family and friends at all for prolonged periods and had concerns about the impact that lockdown could be having on their wellbeing.
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Content ArticleLoneliness and social networks may influence onset of Alzheimer's disease, but little is known about this relationship in people with Alzheimer's disease. This study, published in Geriatric Psychology, aimed to explore the relationship between loneliness and social networks (social measures) and cognitive and psychopathology decline in people with Alzheimer's disease. The authors concluded that maintaining or developing a close friendship network could be beneficial for cognition in people with Alzheimer's disease.
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Content ArticleThe report, As if expendable: The UK Government's failure to protect older people in care homes during the COVID-19 pandemic, was published by Amnesty International in 2020. It argues that the UK government, national agencies, and local-level bodies have taken decisions and adopted policies during the COVID-19 pandemic that have directly violated the human rights of older residents of care homes in England – notably their right to life, their right to health, and their right to non-discrimination. The report states that decisions and policies have also impacted the rights of care home residents to private and family life, and may have violated their right not to be subjected to inhuman or degrading treatment.
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News ArticleSending thousands of older untested patients into care homes in England at the start of the coronavirus lockdown was a violation of their human rights, Amnesty International has said. A report says government decisions were "inexplicable" and "disastrous", affecting mental and physical health. More than 18,000 people living in care homes died with COVID-19 and Amnesty says the public inquiry promised by the government must begin immediately. According to Amnesty's report, a "number of poor decisions at both the national and local levels had serious negative consequences for the health and lives of older people in care homes and resulted in the infringement of their human rights" as enshrined in law. Researchers for the organisation interviewed relatives of older people who either died in care homes or are currently living in one; care home owners and staff, and legal and medical professionals. Amnesty said it received reports of residents being denied GP and hospital NHS services during the pandemic, "violating their right to health and potentially their right to life, as well as their right to non-discrimination". It adds that care home managers reported to its researchers that they were "pressured in different ways" to accept patients discharged from hospital who had not been tested or had COVID-19. Amnesty says the public inquiry into the pandemic should begin with an "interim phase". "The pandemic is not over," it added. "Lessons must be learned; remedial action must be taken without delay to ensure that mistakes are not repeated." Read full story Source: BBC News, 4 October 2020
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News Article
Coronavirus: Delirium 'key symptom' in frail older people
Patient Safety Learning posted a news article in News
Doctors and carers should look out for signs of confusion or strange behaviour in frail older people because it could be an early warning sign of COVID-19, research suggests. Even if they have no cough or fever, delirium is more common in vulnerable over-65s than other, fitter people of the same age. But it's not yet clear why this extreme confusion or delirium happens. In this King's College London study, data from more than 800 people over the age of 65 was analysed. They included 322 patients in hospital with COVID-19, and 535 people using the Covid Symptom Study app to record their symptoms or log health reports on behalf of friends and family. All had received a positive test result. The researchers found that older adults admitted to hospital who were classified as frail were more likely to have had delirium as one of their symptoms, compared with people of the same age who weren't frail. For one in five patients in hospital with Covid, delirium was their only symptom. The study calls for more awareness of it in hospitals and care homes. Read full story Source: BBC News, 30 September 2020 -
Content ArticleThis is the first study, published in Age and Ageing, demonstrating higher prevalence of probable delirium as a COVID-19 symptom in older adults with frailty compared to other older adults. This emphasises need for systematic frailty assessment and screening for delirium in acutely ill older patients in hospital and community settings. Clinicians should suspect COVID-19 in frail adults with delirium.
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EventuntilThe COVID-19 pandemic has put a spotlight on the rights and needs of older persons. While everyone has been affected, evidence shows that older people are among those most at risk of complications from the disease, with fatality rates for those over 80 years of age five times the global average. They are also at greater risk of poverty, discrimination and isolation. Older persons have been hit particularly hard by the virus itself but it has been the failure to protect their rights in the response that has led to unnecessary deaths, unmet health and care needs, increased isolation, discrimination and stigma. This webinar will: Recognise the impact of COVID-19 on the wellbeing and dignity of older persons across the Commonwealth. Raise awareness of ageism, stigma and discrimination against older people in the COVID-19 response and the need to foster intergenerational connections across the Commonwealth. Reflect on how The Commonwealth needs to adapt to ensure the rights of its citizens of all ages are respected. Register
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) report sets out a case where a medication error with warfarin contributed to the death of a 79-year-old man. The patient had suffered a fall at home and had been admitted to hospital. An error on his chart whilst he was on the ward led to him receiving four or five doses of warfarin, which he did not normally take, before the error was spotted by a ward-based clinical pharmacist. The patient developed internal bleeding and deteriorated (due to several health reasons) and died 21 days after his first admission. Research published this year suggests that medication errors may directly cause around 712 deaths per year and indirectly contribute to 1,708. The report highlights the growing ageing population and that pharmaceutical care of older people can be complex. They are often taking multiple medications and are at the greatest risk of harm due to medicine-related errors.
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Content ArticleA fundamental shift is underway in care provision for older populations, with long-term care (LTC) increasingly taking on care provision that was traditionally delivered in hospitals. As OECD populations are rapidly aging, there has been increasing demand on the LTC sector to provide care for more, and older people, with complex conditions and heightened needs for expert care. Currently, 58% of adults aged 65 or over report living with two or more chronic diseases, with this figure rising over 70% in many OECD countries. Simultaneously, trends in LTC focus on substitution of care settings from nursing homes and residential care towards home care and supporting older persons to live on their own or with family as long as possible. The total cost of avoidable admissions to hospitals from LTC facilities in 2016 was almost USD 18 Billion, equivalent to 2.5% of all spending on hospital inpatient care or 4.4% of all spending on LTC. Research shows that over half of the harm that occurs in LTC is preventable, and over 40% of admissions to hospitals from LTC are avoidable. The root causes of these events can be addressed through improved prevention and safety practices and workforce development—including skill-mix and education. Targeted investments in a number of key areas can have a significant impact by mitigating the main cost drivers of adverse events in LTC.
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Content ArticleThe OSIRIS programme is a major project of research, to understand and improve the shared decision making process for patients at high risk of medical complications as they contemplate major surgery. Led by Barts Health NHS Trust & Queen Mary University London and funded by the National Institute for Health Research (NIHR), research will be conducted with patients, doctors and carers to understand the surgical decision making process. The OSIRIS team aim to understand the values and beliefs about long-term outcomes amongst high-risk patients contemplating major surgery, how these differ from doctors’ opinions, how these affect decisions about surgical treatments, and whether patients’ opinions change once they experience surgery. They will co-design with patients and doctors, a decision support intervention, to provide an accurate and individualised forecast of the risks and benefits of surgery for each high-risk patient. You can find out more about the research methodology and the aims of the project through the link below.
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Content ArticleThe Centre for Ageing Community of Practice resource library brings together a catalogue of reports, studies and infographics on areas of interest to Community members and others interested in evidence around ageing better. From designing age-friendly homes to maintaining physical activity and supporting social connections, browse the library by theme to access a wide range of relevant resources.
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Content ArticleDespite the increasing policy focus on integrated dementia care in the UK, this paper published in Health and Social Care in the Community, argues that little is known about the opportunities and challenges encountered by practitioners charged with implementing these policies on the ground.
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Content ArticleOlder people and people with an intellectual disability who receive long-term care are considered particularly vulnerable to infection outbreaks, such as the current coronavirus pandemic. The combination of healthcare concerns and infection-related restrictions may result in specific challenges for long-term care staff serving these populations during infection outbreaks. This review from Embregts et al. aimed to: (1) provide insight about the potential impact of infection outbreaks on the psychological state of healthcare staff and (2) explore suggestions to support and protect their psychological well-being. They found that research into support for long-term care staff during an infection outbreak is scarce. Without conscious management, policy and research focus, the needs of this professional group may remain underexposed in current and future infection outbreaks. The content synthesis and reflection on it in this article provide starting points for new research and contribute to the preparation for future infection outbreaks.
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Content ArticleAccording to experts, older adults with or without pre-existing chronic conditions are at higher risk of COVID-19 infection and are also more likely to have severe cases requiring intubation, ventilator support, and intensive care. In fact, the CDC reports that about 8 of 10 COVID-19 deaths in the U.S. have been adults over the age of 65 years, with the majority over 85 years of age. The risk of contracting and dying from COVID-19 is an even greater problem in the almost 16,000 U.S. nursing homes, where there are concentrated numbers of older adults with chronic disease and frailty. This PSNet Patient Safety Primer looks at the patient safety problems for older adults.
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Content Article
CPSI: Keeping seniors safe (15 May 2020)
Patient Safety Learning posted an article in Older people
The goal of this virtual discussion is to explore practical solutions for keeping seniors safe. The ideas are drawn from real life experiences noting how COVID-19 impacted seniors, their loved ones as well as healthcare workers and leaders. The focus of the discussion is on identifying safety risks together with practical solutions for seniors who live at home, in residences and long-term care facilities. Watch the webinar on demand and download the slides. -
News Article
How specialist A&E for over-80s is transforming care
Patient Safety Learning posted a news article in News
An emergency unit at a Norwich hospital has reduced ward admissions and is helping shield urgent non-COVID-19 patients. The older people’s emergency department (Oped) – a special unit at the Norfolk and Norwich university hospital – is providing emergency care for patients over 80. Launched in 2017, the unit, just down the corridor from A&E, has six beds, two in side rooms and no waiting room. Normally, it admits patients identified as frail and usually with multiple conditions that need a lot of care (such as cognitive impairment, incontinence or reduced mobility). They are brought straight in by ambulance or trolley from other parts of the hospital and seen by a consultant geriatrician within two hours. A team of nurses with experience in both emergency care and care of the elderly, pharmacists and physiotherapists are on hand to support patients much more quickly than A&E to get patients out of hospital and back home within the same day wherever possible. For patients who need to stay longer after treatment there is an adjacent ambulatory ward. This unique model is showing results. The proportion of the specialist department’s patients admitted to the hospital is 50% compared with 68% for the same age group of emergency patients coming to the hospital five years ago, when they were treated at the normal A&E. When Oped patients are admitted, their average length of stay is 1.2 days less. “It’s just what we want for old people,” says Dr Sarah Bailey, the department’s lead consultant geriatrician. “We get the experts in straight away because we recognised that’s the best thing for [them]”. During the pandemic, the unit is helping to keep those who do not have coronavirus symptoms, such as those with injuries from falls and some stroke patients, away from the main A&E ward, providing a degree of shielding not normally possible. But for most NHS trusts, providing a separate unit like Oped is not feasible. “Hospitals are working to separate emergency patients with respiratory problems from those with other conditions,” says Dr Jay Banerjee, who leads the Royal College of Emergency Medicine’s work on emergency care for the elderly. “But most just do not have the capacity to also try to separate elderly patients with other conditions from younger patients.” Read full story Source: The Guardian, 27 May 2020 -
Content Article
Age UK: Getting help after hospital discharge
PatientSafetyLearning Team posted an article in Discharge
This webpage from Age UK gives advice on how elderly people can get support after they have been discharged from hospital. Content includes: How will I be assessed for help? Will I have to pay for help at home? What are intermediate care and reablement services? How do I arrange my own homecare after hospital discharge? -
Content ArticleThis report, from the International Long Term Care Policy Network, provides examples of the policy and practice measures that have been adopted internationally to prevent COVID-19 infections in care homes and to mitigate their impact. This is a 'live' document that will be updated regularly and expanded as more information becomes available.
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Content ArticleBBC Radio 4's You and Yours programme discusses the impact of coronavirus on social care and asks listeners if they feel their relatives in care are being properly protected? One listener, Amanda, speaks about the recent loss of her father who had Alzheimer's Disease. Following a fall and a hospital admission, he contracted the virus. A second caller, Bill, talks about the challenges and risks associated with needing care and support at home as a disabled man. Follow the link below to hear the full programme. This feature aired on 14 April 2020.
