Banglore Talk

Today’s Talk

  • Geriatric Medicine in England
  • Frailty- frailty identification tool, flag and register
  • Comprehensive Geriatric Assessment
  • Deconditioning awareness campaign

I am not here today to teach you medicine –my focus will be on Geriatric medicine in England. I will share with you some of the success stories and challenges we are facing in UK, Also a small discussion around what we are aiming for and how identifying and preventing with frailty is part of my routine work as I work in Frail Elderly Assessment Unit. I am Not qualified to comment on Indian Healthcare but
I am also interested to see how much resonance these issues have for you

There is still much to be done, but there has possibly never been a better time to be old and ill or disabled in the UK. A key component of this success is teamwork. A successful service for old people depends on the skills of many people, including nurses, therapists, social workers, and others.

Reported prevalence of disability clearly rises with age. We also need to understand how the severity of disability varies with age.

Electronic Frailty Index

  • John Young and Andy Clegg et al.
  • Martin Vernon (NCD)
  • Rockwood et al
  • Find
  • Recognize
  • Assess
  • Intervene
  • Long term

Preventing (managing) frailty

Identifying Frailty Is the Key:
Slow gait speed, the PRISMA questionnaire, the timed-up-and-go test, The Edmonton Frail Scale
Provide training in frailty recognition to all health and social care staff
Fit for Frailty (BGS)
Preventing Frailty
Primary prevention
Healthy lifestyle
Secondary prevention
Disease management
Tertiary prevention
Comprehensive geriatric assessment

Frail older people are different…Frailty is a distinctive health state related to the ageing process in which multiple body Non-specific presentations
Homeostatic failure
Multiple comorbidities → polypharmacy
Functional decline

Comprehensive Geriatric Assessment

Key components of geriatric medicine

  • Co-ordinated multidisciplinary assessment
  • Identification of medical, functional, social and psychological problems
  • The formation of a plan of care including appropriate rehabilitation
  • The ability to directly implement treatment recommodations made by the multidisciplinary team
  • Long term follow-up

Ellis G, Whitehead M, Robinson D, O’Neill D, Langhorne P. Comprehensive geriatric assessment for older adults admitted to hospital: a systematic review (prototcol) (2006). The Cochrane Library 2008, Issue 3

What are we aiming for?

  • Outcomes
  • Quality
  • Safety
  • Efficiency
  • Evidence based
  • Patient experience
  • Sustainability

If one looks after the basics quality will follow