Effectiveness of a brief video based intervention on the intention to book future vision and hearing assessments.
Evaluation of a New Frailty On-Call Shift for Geriatric SpRs at St Thomas' Hospital (STH)
Introduction Frailty-attuned acute hospital care is a vital component of integrated services for older people. The NHS Long Term Plan requires hospitals with major emergency departments to deliver 70 hours of acute frailty services each week. Workforce limitations often prevent services from meeting this target and expanding. Geriatric specialist registrars (SpRs) must gain experience in acute frailty so that the consultant workforce of the future can meet patient needs effectively. St Thomas' Hospital (STH) Acute Frailty Service expanded hours of operation through the introduction of a
Improved Discharge Summaries for Older Patients: A Step Toward Better Continuity of Care with Comprehensive Geriatric Assessment
Introduction Effective communication between primary and secondary care teams is essential for providing continuity of care in the community for older people with frailty. Discharge summaries often lack information captured in a comprehensive geriatric assessment (CGA). Junior members of the team, tasked with writing discharge letters, have not been formally taught in this area. This project aimed to incorporate key CGA domains into discharge summaries. Methods The geriatric medicine department at Broomfield Hospital and community mid virtual frailty team identified 7 core CGA domains for
Lumbar Puncture to Diagnose Alzheimer’s Disease Within A Geriatrician-Led Memory Service Is Well-Tolerated
Introduction With the emergence of disease modifying treatments for Alzheimer’s disease (AD), there is an increasing emphasis on the earlier detection and diagnosis of AD. Cerebrospinal fluid (CSF) sampled using lumbar puncture (LP) can be used to establish a biological diagnosis of AD. One potential obstacle to the widespread adoption of CSF biomarkers for AD diagnosis has been a perceived association with poor patient tolerability and safety of LP. LPs have been undertaken within our Geriatrician-Led Memory Service since May 2022. Patients are provided with a written information sheet prior
Older adults are now the face of Major Trauma in Ireland
Using the Irish Hip Fracture Database to drive improvement in Older Adult Care
Factors influencing fall prevention programmes: The challenge of implementing the FaME programme in a complex landscape.
Comparison of Free-Cog with the Mini-Mental State Examination and Lawton-Brody Functional Scales
Introduction: The Free-Cog is a brief cognitive test designed to capture decline in both general cognition and executive function. The Free-Cog has been validated by comparison with the Mini-Addenbrooke Cognitive Examination in a UK secondary care setting. Here, we compare Free-Cog to the routinely-used Mini-Mental State Examination (MMSE) and the Lawton-Brody Instrumental Activities of Daily Living (IADL) and Physical Self-Maintenance Scales (PSMS). Methods: Patients from three memory clinics were recruited (n=318 records). The Free-Cog, MMSE, IADL and PSMS were administered in-person (n=288)
Reliability and Repeatability of a Portable Bio-Impedance Measurement Device in Early Parkinson's Disease
Introduction: Parkinson's disease (PD) is an age-related neurological condition characterized by bradykinesia, tremor, and postural instability. Weight loss within the first year of diagnosis is associated with poor prognosis. Studies suggest that if older adults lose skeletal muscle, their risk of falls and related injuries increases. Therefore, measures of body composition (e.g. muscle, fat) are important in PD, where the risk of falls is high. Established body composition analysis equipment is bulky and only used in research settings. We tested the reliability of a portable SECA mBCA 525
Daily fluid intake is reduced in people with early Parkinson's disease compared with controls
Background: Parkinson's disease (PD) is an age-related neurodegenerative condition with a range of motor and non-motor symptoms. Early non-motor symptoms include constipation and orthostatic hypotension, while dysphagia is common in established PD. Previous work by our group showed that many people lose weight within a year of diagnosis. This study explored if fluid intake was also reduced in people with newly diagnosed PD. Materials and methods: We invited people with newly diagnosed PD (within six months of a diagnosis or longer if not requiring treatment) to join the study. Controls were
Promoting the reduction of sedative use in older adults with delirium – A QI project
Introduction: Non-pharmacological de-escalation techniques are effective in managing agitated patients with delirium, yet are often overlooked in favour of pharmacological management. Sedatives are prescribed despite increased falls and extrapyramidal side effects. We used quality improvement methodology with the aim of reducing sedative use in older adults with delirium in an acute UK hospital. Methods: Utilising inpatient electronic prescribing records, we collected data on all patients aged ≥65 prescribed a sedative acutely during May 2022 in a 575-bedded acute district general hospital
Measuring vitamin D post hip fracture – should we test or just treat? Lessons learnt from an ortho-geriatric rehab unit.
Evaluating a Frailty Same Day Emergency Care Service: Patient and Family Perspectives
Development of a Regional Referral Pathway for Older People to the Medicines Adherence Service, from the Northern Ireland Ambulance Service
Title Evaluation of a new regional pathway for Medicines Optimisation in Older People (MOOP) medicines adherence pharmacist optimising medicines in older people referred by Northern Ireland Ambulance Service (NIAS) Authors & Provenance PCrawford1; SJohnston1; PGalbraith1; PTennyson1; CDarcy2; CMcGuigan2; KMiller3; JPatterson3; JAgnew4; JMcGennity4; HMcKee5; ACunningham5; CStevenson5; KBloomer6. MOOP Pharmacy Medicines Adherence Service, Belfast Health and Social Care Trust MOOP Pharmacy Medicines Adherence Service, Western Health and Social Care Trust MOOP Pharmacy Medicines Adherence Service
Route to a Streamline Transient Ischemic Attack Pathway: A Quality Improvement Initiative
Anticholinergic Burden, Falls and Mortality in a Diverse Older Population in Kuala Lumpur
A Quality Improvement Project assessing the delivery of music therapy on a Care of the Elderly Ward and its impact on patients with dementia and delirium
Introduction Music therapy (MT) can alleviate the behavioural and psychiatric symptoms of dementia (BPSD) but it is not a standard intervention. NICE recommends MT to improve wellbeing in patients with dementia. On our Care of the Elderly (COE) wards, MT is carried out by a qualified music therapist once a week, in groups, individual sessions, or both. This quality improvement project (QIP) aimed to establish what, if any impact, MT, as it was currently provided, had on BPSD, in the setting of a general district hospital ward, thereby also potentially setting new standards which could be used
Reducing anticholinergic burden (ACB) within the healthcare for older people’s (HCOP) wards
Introduction Medications with anticholinergic properties can have significant adverse effects, particularly in older adults. An Anticholinergic Burden (ACB) score of ≥3 is associated with increased risks of falls, cognitive impairment, and mortality. Additionally, side effects such as urinary retention, visual disturbances, and constipation are frequent contributors to delirium. Aim To assess whether raising awareness of ACB within the Healthcare of Older People (HCOP) department can lead to a reduction in ACB scores. Methods Over four months, a teaching session and a poster was disseminated
Functionality in post-COVID 19 older adults vs older adults who have not suffered from COVID 19 attending Geriatric OPD
Introduction: Coronavirus disease 19 (COVID-19) has had lasting effects on the health of individuals, particularly older adults specially those with comorbidities, who are more vulnerable to severe and long term illness. Studying the post-COVID 19 period in the older population is relevant for understanding the long-term effects of the disease. There have been conflicting results on functional decline in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in post COVID 19 older adults compared to their pre-infection baseline. This study aimed to compare
Sex Differences in the Associations Between Social Vulnerability, Frailty, 5-year Survival and Long Term Care Home Entry
Introduction: Frailty and social vulnerability use deficit accumulation approaches to understand heterogeneity in older adult health outcomes. We examined sex differences in the effect of frailty and social vulnerability on 5-year mortality and long-term care home (LTCH) entry in Nova Scotia, Canada. Methods: We followed community-dwelling older adults 65 years and over who were assessed for public home care supports from 2005 to 2018 using data from the Resident Assessment Instrument. We conducted sex-stratified and sex-disaggregated Cox proportional hazards analyses, adjusting for age