Posters for 2023 Autumn Meeting

Introduction by 2025 over 1 million people will be diagnosed with dementia in the UK. Person-centred care is the best practice for looking after patients with dementia, but this is often not managed well within acute hospital settings. This can result in poor hospital experience and longer than necessary stay. A snapshot of data was taken retrospectively from May 2023 within the ED & AMU at an acute hospital. This showed an average length of stay (LOS) of 5.25 days. A study in 2013, which implemented This Is Me (TIM) documents in hospital saw a reduction in inpatient falls, improved patient

Introduction Oncogeriatrics is relatively new concept aligning geriatric services with oncology, whereby older cancer patients have a comprehensive geriatrics assessment (CGA) to support oncology decision-making and improve outcomes and quality of care. Despite the rationale, evidence for effective oncogeriatric services are largely based upon specialist centres. We initiated a feasibility study February 2021, to establish criteria and pathway implications for an Acute Trust without oncology beds. Method Following an iterative process, a pathway was established between the Lung MDT and the

Introduction Improving delirium screening in hospital patients is a recognised important goal to improve patient outcomes, with consequences of delirium including increased mortality, falls, length of stay and dependence on discharge. We undertook a rolling audit over 8-years to examine the use of screening tools to identify delirium and how many cases of delirium were potentially missed in acute medical inpatients in a District General Hospital. Methods 4 cycles of audit were completed over an 8-year period (2015–2023) through a snap-shot prospective review of all acute medical inpatients

Background: The UK has an increasingly frail ageing population, with rising numbers presenting to Emergency Departments (ED’s), with subsequent admission to hospital wards. Older adults living with frailty have longer waiting times in ED’s, are more likely to be admitted and have longer lengths of stay. Introduction: The NHS Long Term Plan requires hospitals to provide an Acute Frailty Service (AFS) for at least 70 hours/week and complete a Clinical Frailty Score (CFS) within 30 minutes of arrival3 . The plan also advocates Same Day Emergency Care (SDEC) to reduce admission related harms and

Introduction Hearing loss affects 12 million people in the UK, it can have a severe negative impact on individuals, especially their communication, cognition and quality of life. Commonly reported effects of hearing loss are social isolation and mental health problems (e.g. anxiety and depression). There are a number of interventions for hearing loss, including hearing aids and cochlear implants. However, many individuals delay seeking treatment. This may be due to limited ­awareness of hearing loss and its consequences amongst the public. In addition, there is a large stigma surrounding

Background The East Kent Frailty Home Treatment Service (Frailty HTS) provides person-centred, hospital-level care for people living with frailty. The Frailty HTS can diagnose and treat acute medical illness at home or in care homes. The team philosophy is “we identify what you want and strive to make it happen”. This project was underpinned by advance care planning for people living in care homes, which the frailty team supports through proactive work with the primary care network care homes teams. Frailty is associated with increased healthcare costs and poor outcomes associated with

Introduction: Optimal intrinsic capacity (IC) is crucial for preserving the functional abilities of older adults. The presence of multimorbidity is closely associated with IC impairments. Various multimorbidity indices have been developed for diverse health outcomes. This study aimed to compare the performance of six commonly used multimorbidity indices to discriminate IC impairments among community-dwelling older adults. Method: We used data from a multidimensional geriatric assessment program including 627 community-dwelling older adults in five cities of Hunan, China. Six multimorbidity

Introduction: It is well established that older adults with hip fracture benefit from comprehensive geriatric assessment (CGA), but there is less evidence for its use in major trauma. Since 2012 Major Trauma Centres(MTCs) have opened across the UK, with varying access to CGA. We report the requirement and impact of CGA in a MTC in its first year of opening. Methods: We reviewed all adult patients admitted under the South-East Scotland MTC included in the Scottish Trauma Audit Group (STAG) database from 1st November 2021 – 31st October 2022. We compared: patients under 65y, patients ≥65y who

Introduction Patient and Public involvement is a cornerstone of the DREAM (Digital and Remote Enhancements for the Assessment and Management of older people) project. An advisory group of 10 diverse older people and carers was established to shape the research through regular discussions and explore inclusive involvement approaches for future work. Methods We conducted a reflective process evaluation to highlight the impact of the involvement process on the project and our public partners themselves. We collated impact logs, reflections and feedback from our public partners and an artist

Introduction Comprehensive Geriatric Assessment (CGA) is widely used in the management and assessment of older people living with frailty, however optimal ways of delivering CGA are not well understood. Gait and balance impairments, common in those living with frailty, are assessed in CGA. Advancements in digital technology provide opportunities to improve patient outcomes by digital monitoring, rather than observation-based assessments - which may be less accurate. As part of the Digital and Remote Enhancements for the Assessment and Management of older people living with frailty (DREAM)

Background: Managing agitation and other behavioural and psychological symptoms of dementia (BPSD) is a significant challenge and impacts on quality of life for people living with dementia. The priority is to find effective non pharmacological interventions as drug treatments can have significant side effects. Objectives: This review evaluates the effectiveness of structured physical activity on agitation in people living with dementia Methods A rapid review of the literature was carried out following PRISMA guidelines. Four electronic databases were searched (Cochrane CENTRAL, MEDLINE, CINAHL

Introduction: Best practice tariff for Neck of Femur Fractures (NOFF) includes establishing a bone protection plan (BPP). Optimal management is often delayed due to insufficient vitamin D levels. Here we reviewed the administration of anti-resorptive (AR) therapies when giving vitamin D loading doses over 7 weeks compared to stat high dosing followed by maintenance therapy. Method: Pre-intervention, we reviewed vitamin D levels, treatment given and bone protection therapy administered in all new NOFF admissions over 3 months. We introduced once-only high dose vitamin D therapy in deplete

Background: Care home residents form a large number of admissions to Emergency Departments (ED) across the UK. Over an 8-month period we reviewed care home admissions to ED to provide further insight on these admission types and identify ways to improve care. Method: All patients with a frailty score of 6 or more admitted from care homes to Chelsea and Westminster Hospital ED between 1 st June 2022 and to 31 st January 2023 were included. Data was collected from the hospital computer system and London Ambulance Service (LAS) attendance sheets. Information collected included; care home the

Introduction: A growing body of evidence suggests that metabolic syndrome is associated with endocrine disorders, including thyroid dysfunction. Thyroid dysfunction in patients with metabolic syndrome may further increase the risk of cardiovascular disease, thus increasing mortality. This study was conducted to assess thyroid function in patients with metabolic syndrome and to assess its relationship to components of metabolic syndrome. Methods: A cross-sectional study was carried out among 170 geriatric patients. Anthropometric measurements (height, weight, waist circumference) and blood

Introduction Although hearing loss is the foremost cause of years lived with disability in people over 70, it remains commonly underrecognised [1,2]. Health of the UK signing deaf community is reportedly worse than the general population, often due to resulting undertreatment of associated co-morbidities including visual impairment, falls and dementia [3,4]. Local Problem There is an estimated 21% prevalence of ≥25dBHL hearing loss within the Wolverhampton adult population, this increasing with age [5]. A large number of inpatients admitted to the Older Adult Medicine (OAM) wards at New Cross

Introduction The concept of “polypharmacy” is a well recognised phenomenon, forming a keystone of any comprehensive geriatric assessment. We considered whether a similar concept could be applied to the number of outpatient clinics that patients may attend - a concept we have coined “polyclinic”. We recognise that older populations may have a greater number of comorbidities and, as a result, have more healthcare professionals inputting into their care. Similar to the potential detrimental effects of multiple medications, we were interested to explore if a similar detrimental effect may apply to

Introduction: Care home residents are increasingly presenting to hospitals. In October 2022, a frailty team was formed in our district general hospital, consisting of two SHOs, one SpR and one consultant, with support from pre-existing care home ANP and community resource team (CRT). Focusing on patients presenting to the Emergency Department, their aims were early identification of care home residents in order to optimise their care by facilitating discharge, tackling polypharmacy and seizing opportunities for advanced care planning. Method: Care home residents were highlighted on the ED

Introduction: Patients with learning disabilities (LD) often have complex medical needs resulting in onset of frailty at younger ages. This increases risk of morbidity and mortality following emergency admissions, such as acute fractured neck of femur (FNOF). This risk is further increased by communication difficulties experienced in this group. There is little information about how LD affects the quality of care of patients with FNOF as defined by the national hip fracture standards (NHFS). Methods: This retrospective audit reviewed notes of patients with LD admitted to a teaching hospital

Introduction Verbal autopsy (VA) is a tool used to determine cause of death (COD) in regions lacking routine medical certification. Automated algorithms are widely used to interpret VA data. This study aimed to investigate potential differences in COD between frail and non-frail older people in northern Tanzania. Method This work forms part of a longitudinal study investigating the clinical outcomes of 308 consecutive adults aged ≥60 years following admission to four hospitals in northern Tanzania. Frailty status was established on admission using the Clinical Frailty Scale (CFS) and

Introduction Little is known about how Health Care Professionals (HCPs) conducting Comprehensive Geriatric Assessment (CGA) assess spiritual needs. The aim of this study was to better understand how UK HCPs understand and incorporate assessment of spirituality into CGA for community dwelling frail older people. Methods Semi-structured interviews were undertaken with HCPs who regularly undertake CGA in the community as well as Anna Chaplains (ACs) whose remit is to provide chaplaincy to community dwelling older people. An inductive approach was taken using a topic guide to structure the