Health Matters: 5 February 2013

The next Health Matters public lecture will be held on Tuesday 5 February 2013, from 7-8pm, in the Lecture Theatre, Education & Training. The talk will be presented by Dr Rubina Japanwala, Consultant Orthogeriatrician, and is entitled “Bone Health Matters, or does it?”

The aim of the talk is to increase awareness to improve bone health and to prevent falls and fractures, and will give information about osteoporosis, falls, vitamin D, and fractures.
Dr Japanwala is also the Falls Lead for the Trust.

Members of staff are very welcome to attend this interesting talk.  If you would like to attend please contact the Communications & Engagement Team on ext 1560 (01625 661560) or email us at

This article “Discrepancies in predicted fracture risk in elderly people” is published in the BMJ (Jan 2013) looks at calculators used to estimate fracture risk in elderly people which give widely different results. Mark Bolland and colleagues argue that treatment decisions should be based on calculators using 3-5 year estimates of risk.  Click for full article

King’s Fund: Toolkit for care of frail older people

Royal College of Physicians

Toolkit for improving care for frail older people
This is the third in a series of acute care toolkits which aims to improve the care of the frail older patient. The toolkit, produced in collaboration with the British Geriatrics Society, recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment.

Older people make up 60–70% of hospital inpatients, and most are admitted through an Acute Medical Unit (AMU), making this a key area in which care for older people can be influenced. It can be difficult for doctors to assess frail older patients as they can often arrive at hospital with multiple symptoms or conditions which can make it difficult to deduce the true cause of the admission.

The new six-page toolkit, produced in collaboration with the British Geriatrics Society, recommends procedures for both initial assessment on admission and later Comprehensive Geriatric Assessment (CGA). 

Public Service news roundup

PM pledges £66m for dementia research
By 2015, the government will more than double the amount of money going into research in dementia

”It’s time for a revolution in elderly care”
Frail older people are being exposed to unacceptable standards of care. say two King’s Fund reports

Huge elderly care study’s mixed messages
People in care homes were much less likely to visit hospitals than those who lived in their own homes

”We’re going to work relentlessly to improve lives”
The Prime Minister David Cameron told the Dementia 2012 conference that he was determined to help hundreds of thousands of families by ”taking the fight to dementia”. Here’s his speech

See more from Public Service news.

Kings Fund: Needs of older people

Joseph Rowntree Foundation

A better life: what older people with high support needs value This study is part of Joseph Rowntree Foundation’s A Better Life programme. It aims to provide a framework for understanding what older people with high physical or mental support needs want and value in their lives.

International Longevity Centre

Living beyond 100: a report on centenarians This report considers the policy implications of the growing centenarian population, examining the demography; health and need for social care; housing and wealth; and quality of life for this group. It aims to understand more about this group through summarising evidence about the lives people lead past 100, while identifying gaps in the evidence base and proposing key policy recommendations to address the issues raised.

Kings Fund: Close to home

Equality and Human Rights Commission (EHRC) Close to home: an inquiry into older people and human rights in home care. The inquiry has found that although many older people receive care at home which respects and enhances their human rights, this is by no means a universal experience. It uncovered areas of concern in the treatment of some older people and shortcomings in the way that care is commissioned by local authorities. Full report Executive summary EHRC – inquiry into home care of older people EHRC – press release

A Critical Pathway for the Frail Elderly Cardiac Patient

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine:
December 2011 – Volume 10 – Issue 4 – pp 159-163

A Critical Pathway for the Frail Elderly Cardiac Patient
Wit, Mirjam MSc; Schaap, Annet MSc; Umans, Victor MD, PhD, FACC


Background: The medical community needs to better respond to the predictable complexities associated with admission of frail and elderly cardiac patients who may need specific attention and care programs. The nurse practitioner can play an important role to continue and coordinate nursing and medical care. We propose a new critical pathway designed to improve cardiac and nursing care for frail elderly cardiac patients admitted with heart failure or atrial fibrillation.

Method: The critical pathway is developed by the nurse practitioner who will act as a pathway coordinator and take care of the medical care of these patients in a teaching hospital setting. This critical pathway is applied to all patients aged >75 years who are admitted for heart failure or atrial fibrillation.

Continue reading

Developing and Evaluating Clinical Practice Guidelines: A Systematic Approach

Levin, RF. 
Evidence based Geriatric Nursing Protocols for Best Practice – 4th edn 

Clinical decision making that is grounded in the best available evidence is essential to promote patient safety and quality health eg: guidelines for falls prevention recommend developing a protocol for toileting elderly, sedated, or confused patients …