The most significant, particularly for older people (the definition of older is anyone who is older than you) when the effects of ageing can impair balance, coordination, and reflexes.
Tag Archives: falls
It’s not all about falling over
One of those instances that over time becomes part of how you see the world.
Thursday morning. Not another blog about advance care planning!
If this narrative has held together, my point is, we can offer just as good, if not better care, treatment and support for particularly older people in their own homes than is available through high-tech medical interventions.
Anticoagulation and possible head injuries in care home residents
Consequently, significant numbers of very frail and older people are transferred to local Emergency Departments following either trivial head injuries or when a head injury is only suspected but not witnessed.
G. falls over and possibly bangs his head
He was treated with antibiotics and returned to the care home 48 hours later. During his stay he fell twice on the ward; there was an incident with a member of staff which led to him receiving intramuscular Lorazepam.
Doctoring, fast and slow.
In life, there are those who work and act quickly; my mum would say, ‘chick-chak’ which I think is a derivation of Hebrew meaning, ‘promptly, without messing about,’ and, those who tend to dilly-dally.
Manor Field Blog #4 Lying and Standing – Know your numbers!
If when you stand-up you become light-headed or dizzy, or, even worse, you collapse or lose consciousness, this is something to address.
Manor Field Blog #2 – I am a GP not.
In the olden days, over 65 was considered old.
Now, when I meet someone who is 75, I consider them young.
To stop, or not: that is the question.
A new class of drugs, originally called ‘novel anticoagulants’ (NOACs) and now, that they aren’t that new, ‘direct oral anticoagulants’ aka ‘DOACs’ have overwhelmed the marketplace
Interruption
You could argue that interruptions are a hazard in themselves, yet, is interruption, or the ability of doctor, patient, porter, nurse, pharmacist or therapist to speak-out or express themselves not part of the tapestry of our safety culture?
Today there was a thing about falls.
Old man. In his nineties, he fell. He fell again after arriving in hospital. What to do with him? He wants to go home; we risk and capacity assess. Determine what is right, good or not and let things happen. We tried to get him home. I can tell you something; he’ll fall again. WeContinue reading “Today there was a thing about falls.”
Little blood pressure thing.
(In health your blood pressure rises when changing position; in disease if it falls, the blood supply to your brain, at times precarious, drops, you feel woozy, light-headed, you fall.)
Falls (Swiss cheese and serious harm)
I wonder What is the rule for hospital Inpatient falls. I mean, There must be some Golden Rule That you can Work-out. How many minor falls For every bad fall. Bad being Broken hip, Brain bleed Death. Interesting ratio to calculate. ‘How many patients have fallen in your hospital inContinue reading “Falls (Swiss cheese and serious harm)”
See you later. I’m going home.
Sure, we know that unnecessary hospitalisation is bad, but what about inappropriate institutionalisation?
Unsafe admission
The example being:
89-year-old woman, lives alone, dementia, diabetes, COPD, has fallen, bruised face – best admit.
And this is the thing.
Medically fit – today and tomorrow (3)
You hear this term all the time nowadays, at least, if you work in an NHS hospital, are an inpatient or carer or relative of someone who is occupying a hospital bed. Most often… Are they medically fit? When will they be medically fit? If they are medically fit, have you done the take-home medicines?Continue reading “Medically fit – today and tomorrow (3)”
Decisive Moment
Cartier-Bresson’s Decisive Moment, my patients falling, examining life and projecting forwards.
Geriatric fall
Tabloids love these figures as it allows them to get away with saying… ‘Hospital H – death rate is twice the national average!’ Subtlety is usually lost in these situations.
Long lie
Two days.
That is a very long time.
Restraint.
Today, when you suffer, I feel pain. I can’t shut out your experience.
We exist as a community, if not we perish as individuals.
Stick
Indeed, the last walking stick I saw came to a bad end when it wasn’t used as a walking stick.
Night at the hospital
There is an assumption that when the lights go down and the night-staff appear on the scene that things become quiet and still – a little like a scene from Bambi.
Just what are we doing?
Snap – your left hip.
1328 and some
‘Did my dad die because someone didn’t follow policy, didn’t pay attention or, was the outcome inevitable?’ ‘Might my mum have survived the operation if she had a different surgeon or she was at a different hospital?’
Medicines, etc.
Nevertheless, within the dark underbelly of medicine, where geriatricians live, there are some quite stunning effects often, from stopping and sometimes starting medicines.
Gut microbiome, antibiotics and older people
We, the homeostatic organisms that have evolved over the past four billion years, exist in a state of serenity when well, but things can be thrown out of kilter by disease.
The Interceptors
The point, as is often the case, is my aversion to patients. Or rather, the existential construct that relates to the ‘patient state’ = they who suffer; with the principal goal of my life being to obviate suffering, my objective is to really stop people turning into patients.
And that is the role of the interceptors.
You don’t know what you’ve got…
And so, to my colleagues, the team of Mallard, I say, here we are – we are something special, we are the exception to the exception that allows magical things to happen.
Habit, hospital & older people
Habits are our liberation, they are also a limitation
Sliding in, struggling out
An old man living alone, is that the problem? Is the problem that it is a problem?
What do you do?
I have recently been asked to show what I do, to demonstrate, I guess, how much value I am for the money spent on me.
Patients in pyjamas
Patients in pyjamas – it might sound a little flippant, but I think this is something that is very important. I cannot comment on the behaviours of other patients outside of the UK – we, in Britain, approach hospital attire in a special way; pyjamas. I don’t know when pyjamas began in hospital – whether backContinue reading “Patients in pyjamas”
Some more thoughts on urine infections…
It is likely that a doctor, a nurse or carer admitting, ‘something is wrong, I don’t know what,’ is better than heading off down a therapeutic blind alley.
Falling over & knots
I hate it when one of my patients falls over on the ward. Each time this happens, I feel as if I, somehow have personally failed to keep them safe, safe, when they are unwell and at their most vulnerable. It is true, that people falling in hospital is complex, it is equally true thatContinue reading “Falling over & knots”
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