Trisha Elliott Profile picture
May 6 26 tweets 19 min read
Next up at the #bgsconf meeting is @GrahamEllis247, talking about the Older People’s Strategy.

How do we address the health inequalities that afflict our country so badly?

#SDOH #inequality
So many challenges. Older people are often discriminated against and yet are also often quite passive in accepting what they experience.

#bgsconf
Older people are most likely to breach the #FourHourTarget in the #EmergencyDept.

#bgsconf
Work in @MidlothianHSCP on #Frailty revealed that greater frailty increase your chances of being admitted from the ED.
##bgsconf
Hospitals are, as we know, very poorly designed for older people.
#bgsconf
We need to look at the assets that people have as well as their deficits.

#Frailty #bgsconf
There are opportunities after the pandemic to do things better.

One of the many reasons I like @GrahamEllis247 is that he is eternally upbeat!

(He’s right, of course. We really can do better!)

#bgsconf
Let’s look at good stuff that we can do. What assets can we draw on?

#bgsconf #Frailty #RealisticMedicine
The road map of life has changed over the last few decades.

#bgsconf
Maybe this is where we’re now going? #bgsconf
So what are the risk factors for frailty? And how many of them can we modify?

#bgsconf
What can we do that’s a bit more “upstream”?

#Frailty #bgsconf
Adverts for fitness equipment always seem to feature young and beautiful people…

But actually older people can benefit more from what’s on offer in terms of getting fitter and healthier.

#bgsconf
And yes! It can be done. They are doing it in Oban.

Should we go and visit? @DarrieLorna @drlynnmccallum @sarahjhoran_j

#bgsconf #frailty #exercise
Proactive and preventive care is always a good plan!

But how do we get people to opt in to this and engage with what needs to be done?

From all ages and demographics.

#SocialInequalities
#DigitallyDisadvantaged
Early intervention is great. But we need to identify the right people and get them what they need.

#bgsconf
Another mention for @MidlothianHSCP and their #Frailty initiatives.

I know from my own experiences working there that a lot of their programmes have added great value to older people’s care.

The GP who specialised in looking after frail folk was excellent.

#bgsconf
We need to sort out both scheduled care and unscheduled care.

Getting people fitter before they become unwell has got to be a good thing, hasn’t it?

I’m doing my best… trying to stay relatively fit as I get older!

#bgsconf
Pre op assessment is now quite widely practised around the country.

(Shout out here to @JKDhesi who pioneered this years ago!)

#bgsconf
We need to think about unscheduled care too. We can still plan for that too!

Lots of talk about promoting #HospitalAtHome too. Getting a better balance of care.

#bgsconf
If you do end up in hospital, you’ll do better in a specialised unit for frail patients.

(Interesting as lots of older people say they don’t want to be in a ward with other older people.)

#bgsconf
More on #HospitalAtHome. A big push for this from @scotgov.

Some gaps around Scotland, including @NHSBorders where I now work!
Lots of good stuff about looking at things from an individual perspective and about the life journey.

#bgsconf
We need to talk about “Getting It Right First Time”. Not just for children, but for older people and indeed EVERYONE!

#bgsconf
Good care adapts to the individual person.

#bgsconf
We sum up with @GrahamEllis247’s laudable goal to make Scotland the best place in the world to grow old!

#bgsconf

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More from @Trisha_the_doc

May 6
Some further slides from today’s #bgsconf, this time on Pharmacy support to care homes.

Spoiler: it is a bit variable! ImageImageImageImage
It’s particularly variable how many care homes each Pharmacy team is supporting…

#bgsconf ImageImageImage
So what are the roles undertaken by Pharmacy teams in #CareHomes?

Lots of different things!

#bgsconf Image
Read 6 tweets
May 6
A lovely presentation from Dr Pam Seenan on her team’s work with the Beatson Oncologists to improve care of older people with cancer.

Geriatric Oncology is a whole new sub specialty.

Call the COPS! (Cancer of Older People) team.

#bgsconf ImageImageImageImage
Funnily enough, having a Comprehensive Geriatric Assessment helped people a great deal!

Well done team! 👏👏👏

#bgsconf Image
The team worked with the Maggie’s centre to develop classes and holistic care for the patients attending the Beatson Oncology Centre.

#bgsconf ImageImageImage
Read 8 tweets
May 6
Well that was truly awesome. A presentation from a medical student Maddie Pritchard from Aberdeen on the effects of social deprivation on outcomes for frail older patients.

A complex subject! #bgsconf #SDOH (social determinants of health). ImageImageImageImage
I’ll tweet some of Maddie’s graphs. Some fascinating results, that aren’t straightforward to explain….

#bgsconf Image
Check them out. It’s complicated because frail people in some parts of Scotland are younger than in some other parts. So judging outcomes related to age and frailty vs deprivation is complicated.

#SDOH #bgsconf ImageImageImageImage
Read 5 tweets
May 6
A very interesting account from my colleague and friend, Dr Jane Bishop Miller, at the #bgsconf.

Talking about the #COVID19 pandemic and their local response but a few key findings to share. ImageImageImageImage
Interesting results. The clinicians usually guessed right when the patient did or didn’t have #COVID19.

#bgsconf ImageImageImage
More results. Patients referred with possible #COVID19 had a whole variety of diagnoses!

#bgsconf ImageImageImage
Read 5 tweets
May 6
Lovely to see @l_whyte at the #bgsconf today in Glasgow!

Lots of great work in @NHSLanarkshire on #Frailty and their work as a community multidisciplinary team. 👏👏
There is research evidence to back up what’s being done. GPs and Primary Care Teams can do this, but don’t have time so having the MDT is working well.

#bgsconf
Lots of progress being made and connections strengthened.

#bgsconf
Read 10 tweets
May 6
One of the most inspirational people on my Twitter timeline is @Lyndseydunn7.

Now talking here at the @GeriSoc #bgsconf on delirium and how we need to identify it and manage it in the real life situations we see every day.
It’s very impressive to see what Lyndsey and the @NHS_Lothian team have achieved with their programme.

#Delirium
#bgsconf
We know what the definition is for #delirium, yet the language used in clinical records is often poor. Well said, @Lyndseydunn7 !

#bgsconf
Read 9 tweets

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