Improving older people’s walking and balancing improves quality of life, reduces dependence on health and social care and prevents falls. This guide looks at the importance of taking a full history, assessing gait and balance, and referral to physiotherapy.
Often a key component of Comprehensive Geriatric Assessment in primary care, this guide examines step-by-step how to carry out a multifactorial risk assessment for falls.
Older people with frailty, those with reduced mobility and those with multiple co-morbidities are all susceptible to problems with bone health.
The website 'Staysafe' has been created to signpost people to the wealth of resources and advice available to help them as they get older – including support on nutrition, exercise and accident prevention.
A quality improvement programme that uses specially trained nurses to introduce an evidence based care bundle to reduce inpatient falls
Falls are a frequent and frightening issue for patients and staff, and they have physical and psychological consequences for individuals and society. They are costly in human and financial terms (National Institute for Health and Clinical ExceIlence 2004).
Guidelines from NICE and Public Health England on prevention of falls and fractures, and the diagnosis and management of hip fractures.
Deconditioning and loss of functional abilities in frail older people may start soon after arriving in hospital. Many end up in a care home prematurely because of it. This campaign, with downloadable resources, aims to encourage patients to 'Sit up, get dressed, keep moving!'
Once you've identified that an older person has frailty, what steps you can take to undertake a holistic review, or Comprehensive Geriatric Assessment, in order to manage frailty. And can frailty be reversed?
Fracture services often fail to respond to the true complexity of their older patients’ needs. The Care of Patients with Fragility Fracture (the 'Blue Book', available as a download) sets out best practice in the care and prevention of fragility fractures.
The Falls Workstream is currently contracted (2018-2021) to deliver the National Audit of Inpatient Falls (NAIF), a clinically led, web-based audit of inpatient falls prevention care in acute and community hospitals in England and Wales.
Falling represents the leading cause of unintentional injury in this population with approximately one third of older adults falling each year.
Whenever you are afraid of losing balance in doing something, it means you might have fear of falling.
Between 47 - 90 per cent of people with dementia fall at least once a year. After a fall, they are less likely to recover well, more likely to be hospitalised, are hospitalised for longer and are more likely to require increased care. Louise Allan examines the care received by these patients.
Since the late 1990s when our local falls service was started by Rose Anne Kenny, falls services have moved from novelty to mainstream in the UK’s care of older people landscape. Steve Parry asks whether this service ubiquity has made a difference.
Whenever Professor Karen Middleton sees the Rehab Matters film she knows that the fictional story depicted is playing out in real life in homes across the country. It cuts her deeply, as a physiotherapist, to hear how a lack of access to rehabilitation has changed a life.
Adapting the home can vastly improve its comfort and usability for older people, ensuring they can carry out daily activities safely, comfortably and with dignity. Yet at least half a million people in England are living without the adaptations they need - and this is probably an underestimate.
Osteoporotic fragility fractures are estimated to cost the UK £2 billion a year. This includes the cost of acute hospital stay, rehabilitation and social care. Only a very small proportion of this is invested in pharmacological management and secondary prevention of osteoporosis.
Insomnia is a very common medical complaint, and increases with age. Patients with insomnia often report increased daytime fatigue, confusion, anxiety, and depression. But sleeping tablets may not be the best course, thinks Ilan Matok.
Falls are a major cause of disability and mortality for older people and the problem is likely to increase with an ageing population. Other consequences range from distress, pain, injury and loss of confidence to complete loss of independence. Dr Kawa Amin shows how simulation training can help staff deal with falls better.
Hospital-associated deconditioning is high on the agenda across hospitals in the UK and many hospital trusts have jumped on the ‘endPJparalysis’ bandwagon to encourage patients to get up and get moving. So, what is the current evidence behind exercise in the acute care setting?
Steve Parry wonders whether "frailty" has become a potentially destructive fad, with vast amounts of resources being devoted to the creation of frailty related services for our older population in the absence of a sound evidence base, out of a desire to care for this patient group better.
Debra Quartermaine enthuses about two pilot projects involving weekly dance and movement sessions run on elderly care, stroke rehabilitation and neuro-rehabilitation wards. They enhanced wellbeing and health of older patients through supporting increased movement, more positive moods, and greater socialisation.
Geriatricians talk a lot about post-operative delirium. It is common after surgeries, especially in people with a lot of risk factors (or we could say, especially in the presence of frailty), and even with recovery it makes for a bad experience.
Vertebral fragility fractures have received much attention lately. There is growing literature to support how well vertebral fragility fractures predict future fractures, morbidity and risk of mortality. What is lacking is research exploring the specific cohort of people with vertebral fractures who are admitted to hospital.
Even with reassuring care from clinical teams treating them, older people often need extra support in a ward environment. Can you imagine how frightening such an experience might be for a patient with visual impairment? It’s perhaps no wonder that poor vision is a risk for delirium.
Jess Walter looks at the danger of hip fractures in women and the increased risk that older women have of experiencing osteoporosis, and what can be done.
Walking has been promoted as a way of reducing the risk and progression of osteoporosis. Yet clinical studies have shown that walking does not increase bone mineral density at the spine unless it is performed along with other physical activities, and that even then, improvement is minimal.
The National Osteoporosis Guideline Group released a new Guideline, accredited by the NICE in March 2017, which includes a number of updates relating to fracture risk assessment, management of osteoporosis and treatment recommendations, all highly relevant for older people.
The BGS Autumn Meeting 2016 saw the launch of the BGS Special Interest Group: the Frailty and Sarcopenia Research SIG. The inaugural session, held in the main auditorium in Glasgow’s SECC was attended by several hundred delegates, and so far, over 100 members have signed up on-line to be part of the new SIG. So why do we need this SIG, and what do we hope it will achieve?
Jenny Neuburger discusses her research paper, published Age and Ageing, showing that geriatrician involvement in hip fracture care can improve patient outcomes. Patients treated on wards with higher numbers of geriatrician hours tended to have lower mortality within the 30 days after presentation.
The conference will cover the latest scientific research and the best clinical practice in healthcare of older people. Our ageing population is stimulating extensive NHS service redesign to deal with the challenge of caring for larger numbers of older people both in and out of hospitals.
The day provides a forum for scientific discussion and clinical updates and enables a multidisciplinary audience to share their experiences of best clinical practice in the field of falls and mobility medicine