This month sees the launch of the brand new GM Journal website at www.gmjournal. co.uk. It aims to help healthcare professionals interested in the management of older patients stay up-to-date on the latest news and clinical advances.
Elderly care has never been more important. Recent months have seen the management of the frail older patient hit the headlines more than ever before.
One of the biggest news stories this month was the publication of the Francis report. This was an inquiry into Mid-Staffordshire NHS Foundation Trust following concerns about standards of care at the Trust. Robert Francis heard evidence from patients, their relatives and staff to inform his report and the 18 recommendations he made.
The British Geriatrics Society (BGS) was quick to issue a press release following the report stating that: “Many of the failings in care described in the report affected old and vulnerable patients. Policy, regulatory, organisational, funding and professional lessons must be learnt. Older people are not only the main users of NHS services but they are also a potentially vulnerable group with more complex needs. They deserve the same standard of treatment as we would expect for patients of all ages and this is very clearly set out in both the NHS Constitution and the Equality Act. It is vital that all health and social care staff working with adults (including managers at all levels, the hospital porter and the senior consultant) have sufficient training, skills and expertise in the specific needs of older patients.”
The Francis report follows head of the NHS Commissioning Board Sir David Nicholson’s assertion that: “hospitals are bad places for old, frail people.” He told The Independent that a revolution was needed in the way the health service cared for Britain’s ageing population.
Sir David likened the current plight of elderly patients in hospitals to the “national scandals” resulting from the treatment of mental health patients in large asylums in the 1960s and 1970s, and committed the NHS to massive expansion of community care. “If you think about the average general hospital now, something like 40% of the patients will have some form of dementia,” he said. “They are very bad places for old, frail people. We need to find alternatives.”
Professor Paul Knight of the BGS added: “The Institute of Health Improvement has shown that hospitals are dangerous places for all ages. We are most concerned by repeated surveys which show that health services across the western world are not age attuned, despite the fact that the majority of hospital patients are over 65 years old. There is a pervasive attitude that ‘hospitals are the wrong place for older people.’ This is worrying as Department of Health funded research has shown that care lacking dignity and skill was associated with hospital staff perceiving that older patients ‘should not be there’.”
Frailty was also a topic of debate following the resignation of Pope Benedict XVI due to “an advance age”. Karl Pillemer, a gerontologist and professor of human development at Cornell University, US, said: “Many media reports have emphasised the age angle in this story. But in doing so, people are confusing age with disability. The Pope’s real reason for retiring is that “strength of mind and body … has deteriorated in me.” Being 85, in and of itself, isn’t reason enough to put aside responsibilities. In fact there are huge individual differences in 85 year olds in terms of health and mental ability. As research shows, age alone is not a good reason to leave a job you enjoy.”
GM welcomes the recent diverse range of media coverage on issues affecting older people and hopes this will be channelled into positive changes to the culture of caring for older frail patients.