Three days, 15 points and just starting to recover from the British Geriatric Society Autumn Conference

For the most, this was people showing-off their successes, how many older people they had saved from peril (mostly keeping them out of hospital), how many standard deviations from the mean their intervention had generated and so on.

I am long and thin by the end of the summer… Who am I?

You know the game. A cryptic clue and an unexpected answer. It came to me this evening, when I was discussing my role with colleagues. I am a hospital trained doctor who works in the community and helps older people, although sometimes young ones too. Who am I? I am a geriatrician. Although I hateContinue reading “I am long and thin by the end of the summer… Who am I?”

London to Glasgow (cardiologists and frailty)

First, I wanted to mention Neprilysin (and its inhibitor) as it seems to me to be such a cunning piece of high-tech science it should reach this blog. Then I’ll get to the cardiologists!

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.

DToC

Most readers of my blog will not have heard of this term. I suspect most of those working inside the NHS don’t know of its existence either… DToC – Delayed Transfer of Care. This is how groups of mostly older people are categorised once they are deemed medically fit – (another NHS neologism which tooContinue reading “DToC”

In your sleep – (Safe in heaven, dead/)

It is an odd thought – dying in your sleep. Pyjamas, tooth brush, perhaps a few pages of a novel and no more. Your eyes close and at some point, in the night, heart stops. Dead.   This is what it is to be alive. Precarious, a tightrope of existence or not.   The mechanismContinue reading “In your sleep – (Safe in heaven, dead/)”

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.

Person-centred

Could you Facetime your doctor when you are on holiday in Greece rather than having to wade through the complexities of health insurance (yes, Brexiters) and a foreign health system?

Stop!  

She survived. She could have died – I never asked the question.

Unnatural selection

You are unconscious, the focus for the doctors and nurses is maintaining your physiology with particular attention to your brain and heart.

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.

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.

What is dementia?

Whether we follow the Japanese and find a new name, or work to continue to change attitudes and behaviours, steering people away from the stigma currently associated with dementia is unclear – it is certainly the bogeyman that TB, cancer and HIV once were, we just need to work towards finding better solutions and ways to support people until we find a way out.

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”

Alzheimer’s – what is it?

I guess, after the months that I have been writing about older people, memory and emotion, I should spend some time describing what, in my eyes, is Alzheimer’s disease – bearing in mind that this is my interpretation, rather than say the view you might get from another doctor, whether geriatrician, psychiatrist or neurologist. ThereContinue reading “Alzheimer’s – what is it?”

Reducing restrictive interventions

Take a moment to think of those nurses, healthcare assistants, therapists and domestics who daily see beyond the fear and the worry of an old person, to the human being who is hiding in the shadows, obscured by layers of disease, for they are what keep us human.

The drugs don’t work they just make you worse

  The Verve released this song in 1997 in their album ‘Urban Hymns’. I was living in Dundee at the time and can remember walking down Perth Road singing this as I met my friend Phil who has walking in the opposite direction, singing the same song to himself. It is funny that so manyContinue reading “The drugs don’t work they just make you worse”