Dementia, David Cameron and losing ground

I am no historian. I struggle with details. Dates and times have never been my thing. I am however a reflector. I look at the world around me, absorb its colours and ponder. I was going to say ‘think’ although FEEL is probably more accurate. For once, I will not quote Bruce Lee (Google, ‘almondemotionContinue reading “Dementia, David Cameron and losing ground”

Pressure ulcers (bedsores) & PCHC

I was recently involved in the care of a patient who developed a pressure ulcer. Behind this seemingly innocuous sentence lurks a whole raft of issues, concerns and aspects of modern healthcare. More surprisingly perhaps, I have spoken with several doctors who believe that pressure ulcers, their care, treatment and avoidance are not a medicalContinue reading “Pressure ulcers (bedsores) & PCHC”

Humanism/PCC/Amos and archeology

I have been reading Amos Oz’s book ‘Dear Zealots’ – it is a collection of essays reflecting the place of zealots in our world – the challenge in our relationships with them, their effect upon us and society, with some thoughts for the future, written last year by Israel’s greatest living novelist. In the bookContinue reading “Humanism/PCC/Amos and archeology”

Person-centred mainstream?

I gave my annual lecture to the Sheffield University Medical Students on Thursday. It was the hottest day of the year. I have been standing in front of the students for something like 15 years – since I was training to become what I am today, a doctor obsessed with person-centred care, helping older people,Continue reading “Person-centred mainstream?”

Collected blogs on delirium 2015 to 2018

How many older people enter hospital and never leave? Are never aware that the paramedics who carry them from their living-room floor will never bring them back; their secrets, mementos, curios, stashed-away in corners only to be discovered by relatives when clearing-out the house after they have moved-on or died.

Silly hats, uniforms.

I went back to Doncaster yesterday, to take part in the Person-Centred Care training day we have been running for the past year. On this occasion, I attended as a guest speaker, which was a novelty. I also took with me some colleagues from Rotherham, so that they could get a feel for  the workContinue reading “Silly hats, uniforms.”

Not many years left

I had another interesting discussion with a colleague today. She had heard about my plans to move hospitals and she wished me good luck. ‘I thought about leaving, but as I only have a few years left I am going to stick it out. I understand you have much longer… Go for it.’ This wasn’tContinue reading “Not many years left”

Dementia

OK. It is Dementia Awareness Week 2017. Now, until Sunday the 21st. If you want to see what was going-on last year, look here. Today, we released to the world, via You Tube, our most recent film, focusing on Person-Centred Care and Dementia. Just because you have dementia doesn’t mean you stop being you. DementiaContinue reading “Dementia”

I saw some great practice this week

In fact, I saw two examples of good practice – one was probably better than the other, but both had a positive outcome of patients; I’ll explain. We have been working for the past couple of years on a ‘pathway’ to guide doctors and nurses in the hospital on how to treat those patients who haveContinue reading “I saw some great practice this week”

Obese appendix

Now… I was ear-wigging this morning. I know it is a bad habit, but sometimes you just can’t help yourself. I had been called to see a patient on the surgical ward – an old woman & when I say ‘old’ (rather than ‘older’) – I am justified this time; she was 100. I wasContinue reading “Obese appendix”

Teal, Gouda & Buurtzorg

Today, I am in Gouda, Holland. Tomorrow I am talking at a Microsystems conference in the local Green-Heart hospital. I don’t have much of an idea what it will be like, who will be there or even what I will talk about. Sure, I have a PowerPoint ready; as to whether this is what theContinue reading “Teal, Gouda & Buurtzorg”

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.

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?’

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.

You don’t have ‘x’

  You don’t have ‘x’ – this can be good news for some, for others it doesn’t really help… Let me explain. If a person feels ill or has a specific symptom – (the easier ones tend to be breathlessness, chest pain or cough), there are a fairly standard set of tests or investigations whichContinue reading “You don’t have ‘x’”

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.

Therapeutic lies and false promises…

I have spent the past few days feeling bad – It is strange, when you discover that something you have been doing, that you had considered ‘right’ is explained to be wrong; it is a little like breaking the law when you don’t know something is illegal … I can’t think of an instance (or,Continue reading “Therapeutic lies and false promises…”

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”