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Background: Older adults with multimorbidity are prescribed medicines to manage chronic conditions. Some of these cause anticholinergic side effects which can lead to falls. Introduction: This work originated from the West Yorkshire ACB Task and Finish Group and involved pharmacists in secondary and primary care working collaboratively. The aims were: To raise awareness of ACB across all sectors. To calculate the ACB scores for patients admitted with falls on acute older patient admission wards in two hospitals and refer to primary care for review on discharge if the score is 3 or more
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Abstract Content - Background/purpose: To prepare future physicians to care for a growing aging population, the Canadian Geriatrics Society (CGS) Education Committee formed a working group in 2019 to update the 2009 Core Competencies in the Care of Older Persons for Canadian Medical Students. The goal is to assist medical educators with developing relevant undergraduate medical curriculum. Methods: The working group chose 5Ms model and canMEDs framework to develop the competencies. A modified Delphi process was used. National participants were recruited and three rounds of Delphi surveys were
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Background: The NHS Long Term plan calls for change to deliver proactive community frailty care1. Proactive frailty case-finding outside traditional healthcare settings should be explored2. Aims: To pilot test proactive frailty screening at a community event. Methods: GSTT Musculoskeletal Physiotherapy department hosted a community day in a deprived area of Lambeth, London. Waiting list residents were invited for a café-style assessment. Stalls were available to meet wider needs including finances, wellbeing, Ageing Well and others. Ageing Well (Consultant Geriatrician & Geriatrics trainee)
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Background: The incidence of falls is a major public health issue with one- third of older people falling annually. Consequently, there are many interventions available to prevent falls such as education and exercise training. However, their effectiveness at reducing fall prevalence is minimal due to low adherence, especially amongst ethnic minority groups. There is currently a paucity of research in this area particularly among older adults from ethnic minority groups. Aims: This systematic review aims to identify the main facilitators and barriers to the uptake of fall prevention programs in
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Care of the elderly simulation-based teaching for the multidisciplinary team Introduction Geriatric medicine is inherently complex and requires multi-disciplinary integration. Simulation-based training has been recognised by the Joint Royal Colleges of Physicians’ Training Board and the Royal College of Nursing as a method to enhance learning and improve patient outcomes. This project aimed to develop a multi-professional simulation programme within care of the elderly to mimic the multi-professional clinical practice that takes place on geriatric hospital wards. Methods A total of ten half
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Parkinson’s disease (PD) is a progressive neurological condition which affects approximately 153,000 people in the United Kingdom (1). It classically involves a triad of bradykinesia, rigidity and tremor alongside other significant motor and non-motor features (2). Delayed or missed medications can result in unpleasant motor and non-motor fluctuations (3). Inappropriate management of patient medication has been shown to result in longer length of stay, delayed recovery, and worse overall outcomes (4). Patients with PD have a high risk of complications peri-operatively with evidence showing
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Efficacy and safety of daridorexant in patients with chronic insomnia disorder and comorbid nocturia
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Introduction Chronic insomnia and nocturia are frequently associated, particularly in older adults impacting sleep quality, daytime functioning and quality of life. This study evaluated the efficacy and safety of daridorexant in patients with insomnia and comorbid nocturia. Methods This double-blind, placebo-controlled, two-way cross-over study randomised 60 patients aged ≥55 years with chronic insomnia and self-reported nocturia to 4-weeks nightly treatment of daridorexant 50 mg or placebo. This was followed by a 14–21-day washout period, after which patients received the alternate 4-week
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Introduction The Commissioning for Quality and Innovation (CQUIN) framework sets a 10% minimum and an ideal goal of 30% of acutely presenting patients over the age of 65 to receive frailty assessment scores. Early recognition of frailty helps mitigate risks such as deconditioning. This project aims to assess and improve the adoption of this standard in medical emergency admissions of a Birmingham district general hospital by working with medical admissions teams and frailty services and observing for associated outcome measures. Methodology PDSA methodology was used. Data was retrospectively
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Introduction Older people can commonly experience reduced appetite and it can be assessed very simply by questionnaires such as the Simplified Nutritional Appetite Questionnaire (SNAQ). Decreased appetite is associated with sarcopenia and frailty, which in turn are related to falls. The aim is to assess if screening for poor appetite might aid in predicting risk of future falls by exploring association between appetite score and falls at three and six months in older people with upper limb fracture. Methods A secondary data analysis. Baseline appetite was assessed using the SNAQ, with score
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About 73% of people living with osteoarthritis are older than 55 years. Osteoarthritis can greatly reduce the quality of life. While surgical interventions (including joint replacement) present one approach to advanced and disabling osteoarthritis, non-surgical interventions help people living with the condition to manage pain and maintain optimal levels of functioning. Pharmacological options should be used in combination with non-pharmacological measures at the lowest effective dose for the shortest period of time possible. Lidocaine 5% plasters are used off license in clinical practice to
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Introduction Delirium complicates 10% of admissions. A delay in diagnosis can lead to permanent cognitive decline, care home placement and death. Watford General Hospital’s (WGH) delirium liaison service receives fewer referrals than expected from areas with vulnerable patients such as ITU. This audit sought to understand why and what effect this might have on outcomes. Method The audit team reviewed notes for all >75-years-old in WGH on a single day, looking for delirium risk factors, evidence of delirium and, if present, a diagnosis and management plan. Outcomes were reviewed at 90 days
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Introduction: Following the publication of ‘Call to action: A Five nations consensus on the use of intravenous zoledronate after hip fracture,’ Craigavon Area Hospital began offering IV Zoledronic acid (IV Zol) to patients with a fragility neck of femur (NOF) fracture. However, the administration of IV Zol is based on the bone health assessment, vitamin D level, and requires ongoing post-discharge care. An oral bisphosphonate should be started one year after IV Zol administration. This study aimed to analyse whether discharges from Craigavon Area hospital following a NOF fracture had clear
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Urgent Community Assessment: A realist review of what works, for whom, and in what circumstances for older adults after a fall. P Garraway1; L Woods1; B Raut1; R Dewar-Haggart2; S Lunuwila1; S McKelvie1 1University of Southampton 2University of Oxford Introduction: Falls have a considerable effect on the physical and mental health of older adults. Urgent Community Response (UCR) services are increasing offered as a Community Alternative to aCute Hospitalisation (CAtCH) for falls management. These services often provide a home based assessments following an fall but there is limited
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Priorities for Irish Research into Loneliness among Older People: Results of a Roundtable Discussion
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Background: Ireland has the highest rates of loneliness among EU countries, with those aged 80+ particularly vulnerable. Loneliness is a significant risk factor for various negative health outcomes. To address this, the Loneliness Research Network (LTRN) was established in November 2022 to ensure policy recommendations from Ireland’s national Loneliness Taskforce are informed by robust research. The LTRN’s first initiative aimed to identify research priorities, particularly in gerontology, to guide the future of loneliness research in Ireland. Method: The study was conducted in two phases
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Over a 6 month period, all 92 residents were offered the opportunity to have a ReSPECT conversation and 86 accepted the opportunity. In addition to families/legal representatives, advocacy services were used to enable equitable participation. Digitally-facilitated communication tools were also offered. The vast majority responded positively, and a mutually agreed ReSPECT form was completed. These were stored electronically on NHS systems and shared with the care home in paper format. However, even when offered all available information some residents chose not to have a ReSPECT placing
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A Treatment Escalation Plan is a document that records and communicates a patient’s treatment goals and preferences, should their general health or condition worsen. A TEP can include but is not limited to: resus status, preferred place of care or death, if imaging/IVs/venepuncture is appropriate. Treatment Escalation Plans aim to minimise harm from over or under treatment; provide clear continuity of care between healthcare professionals; and prevent futile or burdensome interventions which may be contrary to patient wishes. TEPs can be recorded on the computer system, TRAK. The aim was to
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Introduction We were wanting to better understand the population of older people accessing a district hospital emergency department, to identify how a front door frailty team could be utilized and estimate the potential impact this could have for the hospital. Method All patients over the age of 65 who were within the Emergency department on 4 consecutive Thursdays between 8am and 4pm were assessed and proposed a potential intervention from a front door frailty team (either to be streamed to an SDEC or community service, receive a review in ED, ward follow up, or no intervention at all). All
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Introduction Frailty in older adults increases risk of hospital admission, prolonged stay, and poorer outcomes. The NHS Long-Term Plan emphasises early identification, admission avoidance, and shifting care into the community to reduce system pressures and improve patient outcomes. Bromley has one of the largest and fastest-growing older populations in South East London. The One Bromley Hospital at Home (H@H) service is a multidisciplinary, person-centred service, integrating step-up and step-down pathways. Dedicated frailty and palliative care arms ensure high-risk patients receive
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Introduction Frail older patients with hearing impairments face significant communication challenges in acute care settings such as the Emergency Department (ED) and Same Day Emergency Care (SDEC). These challenges often lead to misdiagnoses, increased anxiety, and diminished patient satisfaction. Improving communication for such patients is critical to enhancing their care experience, maintaining dignity, and improving overall satisfaction and outcomes. Method A Quality Improvement Project (QIP) was conducted involving ten participants over 75 years who were identified with hearing
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Introduction: In operative patients, frailty results in increased rates of postoperative morbidity and mortality. The BGS guidelines for perioperative care stipulate that all patients over the age of 65 should have a clinical frailty score (CFS) documented within 72 hours of admission. One benefit of recognising frailty and increased risk of death is timely establishment of a ceiling of care (CoC) for patients undergoing emergency surgery, in line with the NICE guidelines for advanced care planning. In our orthogeriatric department preliminary data suggested that the CFS was almost never
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