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The British Geriatrics Society is the professional body of specialists in the health care of older people in the United Kingdom.

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Age & Ageing Journal

Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology.

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Geriatrics 4 Juniors



For medical students, foundation year doctors and medical trainees. Discover Geriatric Medicine - Nottingham - 8 October



Five Years Since Dilnot: are we back to square one?

Commission on Care Blog: Dilnot’s main recommendations – the cap on individuals’ social care costs, the raising of the means tested asset threshold – are nowhere in sight. They appear buried so deep in the long grass that experts are asking whether they will “ever see the light of day”. The cap, due to be implemented this year in April, was postponed by the last government until 2020. The funding gap in social care meanwhile, which has direct consequences for pressures in health services too, has grown to £1 billion per year.

Perhaps the problem with the Dilnot recommendations was that there was never any solid plan, or political consensus, for how they were to be funded. The Commission’s remit was more focused on the balance between the individual’s and the state’s burden. It was assumed, without a great deal of evidence, that a market for insurance would appear to cover the cost of care up to the point at which the government took on the majority of costs. Funding the state’s contribution to adult social care, however, was an unsettled matter.

Dilnot himself suggested that pensioners could start paying national insurance to meet the £2bn a year costs to the state – the first policy to earn the title of “granny tax”. Liberal Democrat Paul Burstow, Minister of State for Care Services from 2010-2012, recommended in 2013 that the lifetime cap be raised to £60,000 and government costs be paid for by cuts to Winter Fuel Payments for wealthier pensioners and establishing a capital gains tax at death. Labour’s Andy Burnham repeatedly proposed an estates tax of 10-15%, which was branded a “death tax” each time it was considered. Interestingly, Conservative MP John Redwood argued that if the money could be found or the cap then it would instead be better spent improving the quality of care hocarerme services than protecting the inheritances of those able to afford care.

Surveys indicate that the public are fairly evenly split between favouring a social care system funded by government through taxation (48%) and individuals paying what they can (25%), or up to the new proposed threshold of £72,000 (22%) with the government picking up the remainder. It is questionable, though, whether or not the elusive cap as currently conceived would really provide a fair and sustainable policy anyway; it doesn’t include accommodation costs, so people could still be paying up to £140,000 before they even reach it, and it would only cover 8% of men and 15% of women entering care at the age of 85.

How memory apps can help people with dementia tap into their past

Guardian: RemindMeCare is the brainchild of Simon Hooper and Etienne Abrahams, who both had family members with dementia. When his mother got dementia, Hooper started to put her life story on to a tablet for her carers to use. “I realised that early memories were the key to communicating with those with dementia and to improving person-centred care, and that it needed tech to record them, so that the memories would not be lost and would be available to each carer in turn,” he says. On meeting Abrahams at a party and discovering that he was building software to store his grandmother’s memories, photos and favourite music, they both realised there was a gap in the market and decided to develop a business. After a year’s planning, they raised money from care experts and crowdfunding and RemindMeCare was born in November 2015.

Samir Patel, owner of Oaklands Rest Home in the New Forest, Hampshire, which has been using the system since May, says: “It’s had a huge impact on our residents. It’s a nice way to engage with your loved one. You can still contribute to their life in a really positive way.”

Not all dementia apps are designed for use in care settings. This month saw the launch of two new apps that people with dementia can use independently (as well as with a carer, if they choose).

£7m project will search for the early signs of dementia

The Times: People’s eyes, gait and blood could all offer early warning of dementia decades before symptoms appear, experts believe. Scientists said that finding clues to spot dementia early was likely to offer the best chance of defeating the condition, as they announced plans to shift the focus of their research to finding biological markers.

Even the magnetic fields generated by nerve cells in the brain will be investigated to see if they can offer clues in a Medical Research Council project involving intensive tests on 250 volunteers.

Professor Simon Lovestone, from the University of Oxford, who will lead the £7 million project, said: “Previous studies have shown changes to the brain as early as ten to 20 years before symptoms arise.”

See also: Hundreds of volunteers to help spot early Alzheimer's (BBC)

NHS crisis plan to cancel operations and appointments as winter draws in

Telegraph: Hospitals are to cancel thousands of operations and appointments in a desperate bid to stop the NHS "buckling" this winter, under Government plans.

Health officials are drawing up contingency measures to attempt to safeguard emergency care by diverting senior doctors from operating theatres into wards and Accident & Emergency departments as winter sets in. The national plan, detailed in evidence to the Commons health select committee, comes amid concern that the NHS is already in the grip of the worst bed-blocking crisis on record. 

The health service is already braced for rolling strikes from junior doctors throughout autumn, after the British Medical Association threatened to hold the “trade union dispute of the century” in protest at new contracts.

Criminalisation of healthcare professionals: do patients benefit?

HSJ: Central to the on-going junior doctors’ dispute is if the deal that we have struck with them is reasonable, in terms of benefits to both them and the NHS. Wrapped up in that is whether they are treated fairly when things go wrong.

Healthcare bodies are at higher risk of corporate or gross negligence manslaughter than other organisations, due to the vulnerable people in their care. In the ever-increasing event that they come under scrutiny for deaths or harm, they need to prove their internal assurance processes are effective, and that they have done everything reasonably practicable to prevent harm. But will increased sanctions and the criminalisation of individual health and care professionals lead to better patient care?

The truth is that there is little understanding of the impact of potential criminal sanction on the behaviour of individual healthcare professionals. Professor Sir Liam Donaldson was very clear in his evidence to the Mid-Staffordshire Public Inquiry that it is generally undesirable to bring the criminal law into the clinical arena, as it inhibits openness and improvement. However, Robert Francis claimed there was a “serious danger that public confidence and trust in the health service will be undermined.” This seems at odds with other recommendations that advocated strongly for transparency and openness to prevent such insufficient care in the future. Read more in the HSJ

Parkinson's could potentially be detected by an eye test

BBC: Researchers may have discovered a method of detecting changes in the eye which could identify Parkinson's disease before its symptoms develop. Scientists at University College London (UCL) say their early animal tests could lead to a cheap and non-invasive way to spot the disease.

Parkinson's affects 1 in 500 people and is the second most common neurodegenerative disease worldwide. The charity Parkinson's UK welcomed the research as a "significant step". The researchers examined rats and found that changes could be seen at the back of their eyes before visible symptoms occurred. Professor Francesca Cordeiro who led the research said it was a "potentially revolutionary breakthrough in the early diagnosis and treatment of one of the world's most debilitating diseases".

One solution to loneliness in old age? Sixty, female and all living under one roof (just don't call it a commune)

Telegraph: In 1998, Shirley Meredeen was in her late 60s and had recently retired from her job as a student counsellor. But she had no plans for a quiet life. 

Meredeen was keen to change the world, or at least the way the world saw older women. In the summer of that year, she attended  a workshop on co-housing at the National Council for Voluntary Organisations (NCVO) in north London. Co-housing is a fundamentally different way of life in which people live close to, but not with, each other. The workshop was life-changing. ‘Madeleine and I went to the pub afterwards and decided to create something similar,’ Meredeen says. Next month, 26 women aged from 50 to 86 will move into a unique community that they've had built in High Barnet, north London.

Ageism must be tackled like racism, says leading nursing academic

Nursing Times: Society needs to challenge ageism more, according to a nursing academic, who has spoken out following the launch of a national “dementia atlas” that reveals a postcode lottery in care.

The comments by Julienne Meyer, professor of nursing at City University London and an expert the care of older people, followed yesterday’s launch of the government’s new dementia atlas. Speaking about the care variations revealed by the map, Professor Meyer, said: “It is interesting that more people are not up in arms about the ‘postcode lottery’ for dementia care. 

“With the aging population and growing numbers of people with dementia, we are all likely to experience first-hand dementia in ourselves or our loved ones,” she said. “However, we tend to avoid the issue until it personally affects us. By this late this stage, we are often lack capacity to take action.”

She added: “I just don’t understand why society does not challenge ageism more in the same way that it seeks to challenge sexism or racism. “Older people, including those with dementia, are the largest client group for health and social care,” she said. “We should take care not to tuck this fact away as a minority issue.”

Calcium supplements increasing dementia risk for stroke survivors, new study suggests

Telegraph: Daily calcium supplements taken by millions of women to strengthen brittle bones could be putting them at an increased risk of developing dementia, scientists have found.

A study of 700 women between the ages of 70 and 92 found stark associations between taking the supplement and dementia among those who had already suffered a stroke or less serious brain-blood flow disorders. Patients who had survived a stroke were found to be seven times more likely to go on to develop dementia if they took the daily supplement than stroke patients who did not, scientists at the University of Gothenberg in Sweden discovered.

Meanwhile, women with white matter lesions, a less serious cerebrovascular condition, who took supplements were three times more likely to develop dementia than women with legions who did not top up their calcium levels.

Hospice launches a national toolkit to help prevent patient falls

On the Wight: Other hospices across the country can benefit from the experience and expertise of a senior member of staff at Earl Mountbatten Hospice with this latest guide on other on managing and preventing falls among their patients.

Hospice UK has just published an updated version of a template which all hospices can use to manage and prevent falls in their inpatient units. The original guidance had been published in 2012, and the aim of refreshing the advice has been to make sure it is consistent with national and international standards, relevant in all areas of hospice care (including at home and in care homes), and as user friendly as possible. The toolkit can be adapted and used to support each individual patient and includes links to national guidance.

How can care homes ensure a good death for residents?

Guardian: Research reveals that care home staff, healthcare professionals, residents and their families may not always agree on end-of-life care

No one goes into a care home with the express intention of dying. At the same time, most residents have a limited life expectancy and the majority will die within two or three years of moving to a home. There is a long list of challenges facing all those involved in providing the best possible support for the 460,000 people living in UK care homes. They become even greater when it comes to caring for the eight out of 10 residents likely to suffer from dementia. They are also compounded by the fact that as many as 27 different NHS services can visit to provide care and treatment for residents. Add to all that a variably qualified care home workforce with inconsistent access to clinical support and what you get is a lot of uncertainty.

If you ask them, care home staff, healthcare professionals, residents and their families would all wish for and want to achieve the same outcome: a good death. But how can that be managed with all the uncertainties at play and with so many people and points of view to consider? What people want, their care needs, how to interpret and treat symptoms, and who becomes involved in the decision making when someone with dementia is dying can become a source of anxiety, upset and frustration for everyone involved. What’s been missing until now is a way of framing those uncertainties that can help make sense of the challenges, acknowledge them and have productive and helpful discussions that bring about the best decisions.

New 'care atlas' reveals disparity in dementia care across UK

Guardian: Atlas shows care review performed for less than half of patients in some parts of England but for nine out of ten in others.

Dementia sufferers are being let down by local services across the country, according to new government data that critics say has revealed a postcode lottery in care for the chronic and degenerative brain disease. An interactive “dementia atlas”, published online on Tuesday by the Department of Health, shows that standards of care vary widely in different areas, with services failing to reach almost half the patients for check-ups even once a year in one area. Jeremy Hunt, the health secretary, said the data would “shine a spotlight” on the areas with the worst performance, and so drive improvements across the country. But political opponents said it revealed a healthcare system struggling to stay afloat.

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