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Found 270 results
  1. News Article
    A health board has been fined £180,000 for failing to protect a vulnerable pensioner who died after repeatedly falling in hospital. Colin Lloyd, 78, was assessed as posing a high risk of falling and required one-to-one care after being admitted to Raigmore Hospital in Inverness. Despite repeated requests for more nursing staff none were made available and the pensioner suffered falls on the ward, which caused fatal injuries. Fiona Hogg, NHS Highland’s director of people and culture, said: “We are deeply sorry for the failures identified in our care. Our internal review following the incident identified several areas of improvement and we have made a number of changes to our practice.” Read full story (paywalled) Source: The Times, 15 February 2023
  2. News Article
    The amount of time people over 80 spend in A&E in England has almost doubled in a year, leaving them at increased risk of coming to harm and dying, emergency care doctors are warning. An analysis by the Royal College of Emergency Medicine (RCEM) found that people of that age are spending 16 hours in A&E waiting for care or a bed, a huge rise on the nine hours seen in 2021. The college, which represents the UK’s A&E doctors, warned that long waits, allied to overcrowding in hospitals and older people’s often fragile health, is putting them in danger. Doctors specialising in emergency and elderly care warned that older people forced to spend a long time in A&E are more likely to suffer a fall, develop sepsis, get bed ulcers or become confused. Dr Adrian Boyle, the RCEM’s president, said that it is also likely that some older people are dying as a result of the delays they are facing, combined with their often poor underlying health. The risks older people face while waiting in sometimes chaotic A&E units are so great that they are likely to be disproportionately represented among the 500 people a week who the RCEM estimates are dying as a direct result of delays in accessing urgent medical help. Read full story Source: The Guardian, 31 January 2023
  3. News Article
    Older women are at higher risk than older men of experiencing adverse reactions to drugs prescribed by their family doctor, and older patients taking more than 10 medicines are at higher risk than those taking fewer, according to a study. Overall, one in four older people experience adverse drug reactions (ADRs) to pills prescribed by their GP, the research published in the British Journal of General Practice suggests. It has prompted calls for GPs to consider deprescribing ineffective medications and prioritise patients taking lots of drugs for a regular review of their prescriptions. The medicines most commonly associated with ADRs included those used to treat high blood pressure and other cardiac conditions, strong painkillers such as tramadol, and antibiotics such as amoxicillin, according to the study. The study monitored 592 patients aged 70 and older across 15 general practices in the Republic of Ireland over a six-year period. One in four experienced at least one ADR. Patients prescribed 10 or more medicines had a threefold increased risk of experiencing a reaction, researchers said. Women were at least 50% more likely to have ADRs than men, the study found. “ADRs can be difficult to identify in medically complex older adults as they often present as non-specific symptoms,” the researchers wrote in the British Journal of General Practice. “GPs are well placed to detect the occurrence of ADRs from drugs prescribed in primary care as well as in other care settings. Deprescribing of ineffective medications and those no longer clinically indicated is one approach to reducing the risk of ADRs in older patients.” Read full story Source: The Guardian, 24 January 2023
  4. News Article
    A man plans to sue a nursing home because, he says, during the pandemic his mother was put on end-of-life care without her family being told. Antonia Stowell, 87, did not have the mental capacity to consent because she had dementia, say the family's lawyers. Her son, Tony Stowell, said if end-of-life care had been discussed, he would not have agreed to it. Rose Villa nursing home in Hull says all proper process in Mrs Stowell's care was followed with precision. As a prelude to legal action, Mr Stowell's lawyers have obtained his mother's hospital records which, they say, show she was diagnosed with suspected pneumonia while living in the home. End-of-life drugs were then prescribed and ordered by medical professionals. In a statement, Rose Villa said: "We believe that our dedicated and professional team provided Antonia with the very best care under the direction of her GP and medical team, and all proper process in the delivery of this care was followed with precision." Mr Stowell's lawyers, Gulbenkian Andonian solicitors, said his mother's hospital records reveal the decision to put her on end-of-life care was made two days before the family was told. In their letter to the home announcing the planned legal action, they said Mrs Stowell could have had "48 additional hours on a ventilator with treatment… with the necessary implication that Antonia Stowell could still be with us today or at least survived". The lawyer dealing with the case, Fadi Farhat, told the BBC: "As a matter of law, there is a presumption in favour of treatment which would preserve life and prolong life, irrespective of one's age or condition. "Therefore to deviate from that presumption means a patient, or family members, should be consulted as soon as that decision is made or contemplated." He adds: "What is particularly concerning for me is this case occurred at the height of the pandemic. That should worry everybody because it demonstrates that rights can be suspended in times of crisis, when the very purpose of legal rights is to protect us during times of crisis." Read full story Source: BBC News, 9 January 2023
  5. News Article
    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
  6. News Article
    The world must urgently prepare for a global “tsunami” of millions of older cancer patients or risk healthcare systems being unable to cope, leading doctors have warned. With life expectancy increasing and a rapidly soaring population of older people, a looming increase in elderly patients with cancer was now a “serious public health concern”, the American Society of Clinical Oncology (ASCO) said in a report. Cancer centres must prepare for “the silver oncologic tsunami”, the experts added. At ASCO’s annual meeting in Chicago, the world’s largest cancer conference, Dr Andrew Chapman, the director of the Sidney Kimmel Cancer Center-Jefferson Health and a specialist in geriatric oncology, said: “As the population expands and the incidence goes way up, are we really prepared to deal with those needs? I think globally, we’re not prepared.” “We know cancer is a disease that is associated with ageing, and there are a number of biological mechanisms as to why that is,” Chapman said. “What is often times missed is that the older adults’ goals, wants, needs, preferences, and issues are much different than those of the average adult. “Sometimes there’s a nihilism – ‘if you’re older we’re not going to bother’ – which is horrible,” he added. Dr Julie Gralow, the chief medical officer and executive vice-president of ASCO, said healthcare systems should act immediately to avoid being overwhelmed by the dramatic rise in older cancer patients. “By 2040, the global burden is expected to grow to 27.5m new cancer cases and 16.3m cancer deaths simply due to the growth and ageing of the population.” Read full story Source: The Guardian, 5 June 2023
  7. News Article
    A new alert system will warn the public when high temperatures could damage their health this summer in England. Run by the UK Health Security Agency and the Met Office, it is aimed at reducing illness and deaths among the most vulnerable as climate change makes heatwaves more frequent. The Heat Health Alert system will operate year-round, but the core alerting season will run from 1 June to 30 September. The system will offer regional information and advice to the public and send guidance direct to NHS England, the government and healthcare professionals. Individuals can sign up to receive alerts directly and people can specify which region they would like to receive alerts for. Dr Agostinho Sousa, head of extreme events and health protection at the UK Health Security Agency, said, "It is important we are able to quantify the likely impacts of these heatwaves before they arrive to prevent illness and reduce the number of deaths." Read full story Source: BBC News, 1 June 2023
  8. News Article
    Extra beds squeezed into hospitals as part of winter planning are crowding out space for rehab, pushing up length of stay and knock-on costs, and increasing the chance of readmission, NHS leaders have been warned. Systems and trusts were encouraged to staff thousands of additional ward beds in the run-up to last winter to try to ease emergency care pressures, and government and NHS England have since asked for many of them to be kept open through the year. However, many of the additional beds are not in proper ward spaces, instead being located in gyms and other areas used for physiotherapy and other rehab. This followed on from some rehab areas already being lost during the pandemic, to be used for beds or storage. NHSE has sent out a warning about the issue, following a commitment by ministers earlier this year. However, senior figures in physio and older people’s care remain concerned the spaces will not be restored without checks and enforcement, especially as acute trusts remain under pressure to increase general bed space.
  9. News Article
    Experts are calling for "do not resuscitate" orders to be scrapped, saying they are being misused and putting people's lives at risk. One woman told BBC News that her elderly father might still be alive if the DNR in his medical file had been properly checked. When Robert Murray began choking on a piece of fruit at breakfast, staff at his care home called 999. He'd stopped breathing and the ambulance service operator immediately sent paramedics to attend. But seconds later, the care home told the dispatcher that the 80-year-old had a do not resuscitate form (DNR) in his medical records. The paramedics were stood down. Mr Murray died minutes later. However, it was all a terrible mistake. It hadn't been made clear to the ambulance service that Mr Murray was choking - the DNR was only meant to apply should he have a cardiac arrest. Mr Murray's death, at a nursing home in Eastbourne in June 2021, is an example of what experts call "mission creep" in the use of DNR - also known as DNACPR (Do Not Attempt Cardiac Pulmonary Resuscitation) - decisions. Researchers from Essex University say some care home residents are "being inappropriately denied transfer to hospital or access to certain medicines" due to the recommendations. Read full story Source: BBC News, 16 May 2023
  10. News Article
    The Government’s “blanket erasure” of older people with learning disabilities is leaving a growing population unsupported and piling further pressure on family carers, new research will warn. Byline Times has seen early findings from a forthcoming national study which outlines the urgent need to avoid a crisis by creating a government strategy for this unacknowledged community. With around 1.5 million people with learning disabilities in the UK, Manchester Metropolitan University (MMU)’s ‘Growing Older Planning Ahead‘ research lays bare the Government’s short-sighted approach to learning disability support. The study estimates around 81,000 over-50s within this population in England alone, many of whom are not in contact with services. In addition, figures show that between 2012 and 2030 in England, the number of learning disabled people needing social care will have increased by almost 70% (from more than 140,000 to 235,000). Sara Ryan, MMU Professor of Social Care who led the three-year project, said: “Ageing opens up all sorts of different things, you turn down the dial on some things and up on others. If you’re lucky enough, you have a lot to look forward to – but for people with learning disabilities, there’s a blanket erasure of age.” Read full story Source: Byline Times, 3 May 2023
  11. News Article
    Today’s generation of elderly people could be the last to face the spectre of untreatable Alzheimer’s disease, according to the co-chair of the government’s new dementia mission. Hilary Evans, the chief executive of Alzheimer’s Research UK, appointed by ministers last month, said the world was “on the cusp of a new dawn” for dementia treatments that meant devastating neurodegenerative illness would no longer be regarded as an inevitable part of old age. However, she warned that an overhaul of NHS dementia care was required to ensure that patients could access the first effective Alzheimer’s drugs, which could be approved in the UK as soon as next year. Evans was appointed last month to co-chair the UK government’s national dementia initiative, which aims to draw lessons from the Covid vaccine taskforce to accelerate dementia research and comes with a commitment to double funding for dementia research to £160m a year by 2024–2025. Read full story Source: The Guardian, 26 April 2023
  12. News Article
    A care home manager said it had become an "impossibility" to get NHS dentists to visit her elderly residents when they needed treatment. Liz Wynn, of Southminster Residential Home, near Maldon in Essex, said she had battled for years for site visits. It comes as a health watchdog revealed that 25% of care home providers said their patients were denied dental care. NHS Mid and South Essex said it was considering a number of approaches to improve access for housebound patients. Ms Wynn said the shortage of NHS community dentists available to come into the home to carry out check-ups and treatment had been an "on-going concern" for almost 10 years. Ms Wynn said the home relied on its oral care home procedures - such as checking residents' mouths daily - to prevent problems from escalating. However, she said while its residents were "our family", conditions such as dementia made it difficult to spot when patients were in pain. She also said poor dental hygiene in the elderly could result in a number of potentially life-threatening infections. Read full story Source: BBC News, 24 April 2023
  13. News Article
    Trust in care homes has slumped, leaving half of the British public lacking confidence that friends or family would be well looked after. Nationwide polling for the Guardian revealed 9 out of 10 older people believe there are not enough care staff, and half have lost confidence in the standard of care homes since the start of the pandemic. The survey conducted by Ipsos this month follows a doubling in public dissatisfaction in the NHS and exposes deepening fears about the fitness of a social care sector that had its weaknesses exposed by Covid-19, which claimed 36,000 lives in care homes in England alone. The Relatives and Residents Association (RRA) said the polling tallied with calls to its helpline about the “harm and anguish caused by poor care and frustration at the inconsistency in standards”. “We must weed out the poor providers and invest in skills – care workers must become our most valued workers, not the least,” said Helen Wildbore, the RRA’s chief executive. “Tomorrow, any one of us could need them.” Read full story Source: The Guardian, 24 April 2023
  14. News Article
    A former nursing home manager has been fined £40,000 after pleading guilty to two offences of failing to provide safe care and treatment to two residents at Rossendale Nursing Home in Lancashire. Caroline Taylforth, who established her first residential care home in 1997, was prosecuted by the CQC. She was the registered manager at Rossendale Nursing Home at the time of the incidents, and admitted mistakes she had made that meant two residents did not receive safe care and treatment, and resulted in "avoidable harm" while in her care, said a CQC spokesperson. The first offence was for failures in the care of resident Patricia Sutton, aged 77, who was admitted to the home on 11 October 2018 and had a significant medical history. On 6 November 2019, Patricia Sutton was eating dinner in the dining room and started choking. She was taken to hospital and died later that day. Ms Sutton had previously been involved in three other choking incidents and should have been referred to a speech and language therapist after the second one occurred to properly assess the risks, said the CQC. However, Ms Taylforth "did not safely assess, monitor or manage the risk or make this referral", the CQC concluded. The CQC also prosecuted Ms Taylforth for another incident concerning Dereck John Chapman, aged 82, who was admitted to the home on 22 October 2019 with multiple health issues and was also prone to having falls. Following admission to the home, Mr Chapman suffered at least 14 falls. Ms Taylforth "failed to mitigate" the risk of falls and "failed to ensure" Mr Chapman was promptly referred to appropriate services, such as the falls team, GP, and local authority following known incidents, particularly those resulting in injuries, criticised the CQC. Read full story Source: Medscape, 6 April 2023
  15. News Article
    Funding promised to develop the social care workforce in England has been halved, the government has confirmed. In 2021 the government pledged "at least" £500 million for reforms, to be spent on training places and technology over three years. But that figure is now £250 million, according to the Department of Health. A coalition of charities said this cut is "just the latest in a long series of disappointments" over social care. The government said its reforms would give care "the status it deserves" but some organisations in the sector say they fall short of what is needed. Caroline Abrahams, co-chair of the Care and Support Alliance - which represents more than 70 charities - and charity director of Age UK, said the measures "aren't remotely enough to transform social care". Millions of older and disabled people and their carers "needed something far bigger, bolder and more genuinely strategic to give them hope for the future", she said. Read full story Source: BBC News, 4 April 2023
  16. Content Article
    A new in-depth report from the Charity Age UK, ‘Fixing the Foundations’, reveals how our under-funded and overstretched NHS and social care system is struggling and sometimes failing to cope with the needs of older people.  The report provides a first-hand account of older people’s difficulties in getting the good, joined up health and social care they need to manage at home, leaving them at risk of crisis which often results in being admitted to hospital. Yet the evidence is clear that with the right care at the right time many of these admissions could have been avoided. The report also includes perspectives from professionals and unpaid carers. It also shows how living with multiple long-term health conditions, as a significant proportion of older people do, including more than two-thirds of those aged over 85, makes it especially hard to navigate health services which are still usually organised around individual illnesses and diseases. Meanwhile social care was often inadequate or absent in these older people’s lives. Age UK estimates that astonishingly, over 1.6 million older people have some level of fundamental care and support need, such as help to get dressed, washed or getting out of bed, that is not being fully addressed.
  17. Content Article
    To date, research on adverse drug reactions (ADRs) has focused on secondary care, and there is limited studies that have prospectively examined ADRs affecting older adults in general practice. This study from Doherty et al. examined the cumulative incidence and severity of ADRs and associated patient characteristics in a sample of community-dwelling older adults. They found that over one-quarter of older adults experienced an ADR over a 6-year period. Polypharmacy is independently associated with ADR risk in general practice and older adults on ≥10 drug classes should be prioritised for regular medication review.
  18. Content Article
    The health service needs to develop innovative ways of treating an increasingly elderly and frail population, while harnessing new technology to help mitigate the staffing crisis. As part of the Times Health Commission, this article outlines some potential solutions — encompassing new ways of working and regulation to promote healthier lifestyles — to some aspects of the health and social care crisis in the UK.
  19. Content Article
    The Fracture Liaison Service Database (FLS-DB) collects, measures and reports on the care provided by Fracture Liaison Services (FLSs). This annual report presents the results of secondary fracture prevention care received by patients aged 50 and older following a fragility fracture between January and December 2021. Based on 70,384 patient records in 2021 (compared with 70,614 in 2019), it found that there has been a reduction in both case identification and assessment performance, but an improvement in treatment recommendation, monitoring and follow up, when comparing national data from 2021 with 2019.
  20. Content Article
    This document summarises the current landscape of virtual wards from the perspective of healthcare for older people, and provides advice to those looking to set up such services for older people living with frailty.
  21. Content Article
    This 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.
  22. Content Article
    The 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
  23. Content Article
    In 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.
  24. Content Article
    For 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.
  25. Content Article
    Medications 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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