Amit Arora

University Hospital Of North Staffordshire NHS Trust · Department of Elderly Care

Background The High Intensity Users (HIU) Team supports individuals with single or multi-morbidities or complex care needs who are high users of Health and Social Care Services. Introduction Stoke-on-Trent has an aged population rising: 65 years plus by 17% increase to 280853; 85 years plus by 38% increase to 39425. Frail older people are the most...

Introduction There has been significant developments, investment and ambition to use modern technology in admission avoidance in hospitals. Sensor technology has been one area of development. Method We used My Sense to improve outcomes for a cohort of High Intensity Users (HIU) frail older patients and compared hospitalisation rates before and aft...

Background: Older people are often explicitly or implicitly excluded from research, in particular clinical trials. This means that study findings may not be applicable to them, or that older people may not be offered treatments due to an absence of evidence. Aims: The aim of this work was to develop recommendations to guide all research relevant...

Lay Summary Respiratory syncytial virus (RSV) causes respiratory illnesses, which can lead to serious complications in older adults. We estimated how common infections due to RSV are in adults living in the community or long-term care facilities. For 2 years, we followed approximately 2000 adults 50 years and older in Europe and the United States....

Background: When patients with advanced dementia lose capacity to make medical decisions for themselves, a 'best interests' determination is usually made on their behalf by the responsible clinician. Where possible, this should be made in consultation with members of the multiprofessional team and the family, consistent with ethical and legal norm...

Elder abuse is still under-reported and under-recognized in many cases. This chapter discusses definitions of elder abuse and key issues related to this serious problem including barriers that prevent vulnerable older people seeking help. This chapter also examines the role of health professionals in early identification and management of elder abu...

Geriatric medicine is a complex speciality treating any condition experienced in the over 65s. With the changing demographic of older age and increasing life expectancy, it has evolved into a speciality of multimorbidity; treating chronic disease and frailty, while attempting to prevent deconditioning. The Comprehensive Geriatric Assessment remains...

With an ageing population, surgical procedures in older patients are becoming increasingly more common. This can pose clinical and ethical dilemmas, during which clinicians need to make complex decisions. In this paper we discuss the importance of assessing mental capacity to assess if the older patient can make his or her own decisions relating to...

SEE http://www.rcpsych.ac.uk/usefulresources/publications/collegereports/cr/cr211.aspx The publication of Our Invisible Addicts in 2011 represented an important landmark in recognising the extent of substance-related health problems amongst older people and that the special service needs to deal with the complexity of such problems, which often in...

The problem of elder abuse is still underreported and underrecognized in many cases. This chapter discusses various definitions of elder abuse and key issues related to this serious problem including barriers which prevent vulnerable older people seeking help. This chapter also examines the role of health professionals in early identification and m...

You have told me all the things I need to hear before I knew I needed to hear them. To be unafraid of all the things I use to fear before I knew I shouldn’t hear them. Lang Leav Ethics and Medical Ethical Principles Ethics is the study of morality or the value dimension of human decision-making and behavior (Williams 2015). Medical ethics is the br...

Objectives To evaluate the feasibility and potential clinical benefits of medicines optimisation through comprehensive geriatric assessment (CGA) of frail patients with multiple conditions, by secondary care geriatricians in a general practice care setting. Methods Seven general practitioner (GP) practices in one region of Stoke-on-Trent volunteer...

With vast improvements in healthcare in recent decades, people are living longer but often with higher rates of morbidity and chronic illnesses. This has resulted in a higher proportion of the population who may benefit from early end-of-life ‘conversation and planning’, but also gives healthcare professionals more time during which these discussio...

The detrimental physical, mental and social effects of substance misuse in older adults are of growing concern. Rates of use and misuse of alcohol and illicit drugs among older cohorts are rising, influenced in part by the attitudes of the ‘baby boomer’ generation. Additionally, those over the age of 60 are significant users of health and social ca...

The subject of abuse and the related issues of dignity, poor quality of care and human rights are the most important issue facing health and social services today. Elder abuse has been defined as a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or d...

A 64 year old lady, with a background history of type 2 diabetes mellitus and hypertension, presented with general deterioration of general health, poor glycemic control, difficulty in controlling blood pressure and difficulty in walking. She had past medical history of adenocarcinoma of the oesophagus, treated with surgery and subsequent chemother...

Lamont and colleagues highlight key concerns about insulin prescribing, but have missed an opportunity.1On call medical registrars in busy acute settings often have …

Peter Crome is president of the British Geriatrics Society and deputy head of Keele University medical school

There is no evidence from randomised controlled trials to guide oxygen treatment after stroke. This survey aims to establish a snapshot of views of clinicians on best current practice relating to the management of hypoxia early after acute stroke. A postal questionnaire was sent to all 231 members of the British Association of Stroke Physicians (BA...

To ask older people about loose or ill-fitting dentures is not common practice during a hospital admission. Our patient presented to the emergency department following a primary respiratory arrest. A dislodged denture was extracted from the hypo-pharynx under local anaesthesia and was presumably the cause of the respiratory arrest. Any delays in fi...

Rechecking the position of the nasogastric tube after oropharyngeal suction is not common practice. Our patient deteriorated after oropharyngeal suction was performed, whilst nasogastric feeding continued. We suggest that nasogastric feeding should be stopped during oropharyngeal suction and the tube position should be checked every time an orophar...

Colonoscopy is the standard investigation for colonic disease, but clinicians often are reluctant to refer elderly patients for colonoscopy because of a perception of higher risk and a high rate of incomplete examinations. Data were prospectively collected on 924 consecutive colonoscopies performed over a 31-month period. Comparisons were made betw...