Posters

Introduction An ageing population globally has created an escalating demand for age-attuned healthcare services. There is however an insufficient number of geriatricians to meet this need. Most older adults will therefore continue to receive their medical care from doctors without specialised geriatric medicine training. It is important therefore that all doctors possess fundamental gerontological competencies. Which specific competencies and how they might best be integrated into medical education remain unclear. Our aim was to summarise the literature on the geriatric medical competencies

Introduction The number of older adults accessing the healthcare service far exceeds the available geriatric specialist services. It is recognised that for the foreseeable future most hospital inpatient contacts with older adults will be completed by doctors not specifically trained in Geriatric Medicine. To ensure the provision of adequate healthcare, it is imperative that all hospital doctors are trained in the minimum Geriatric Medicine competencies. Allowing for the broad, complex, and multidisciplinary nature of Geriatric Medicine, we conducted a group concept mapping (GCM) study to

Introduction Monitored dosage systems (MDS) encompass a wide range of devices to help management of medication. This research uses poison centre data to explore risks associated with their use. Method A search of accidental overdose enquiries to the UK National Poisons Information Service (NPIS) between 1/01/2017-31/12/22, classified as “therapeutic error/medical error” involving patients aged 65 or over was performed. Enquiries involving an MDS were identified. Data were analysed using descriptive statistics and chi-square test. Results There were 394 enquiries concerning 393 patients and

Introduction: There is growing awareness of the harms caused by racial abuse and discrimination from patients towards healthcare professionals, including anecdotal reports of patients ‘requesting a white doctor’ (Kline, BMJ Opinion, 2020); yet there is limited understanding of the impact in Geriatric settings. We conducted a survey in an inpatient Older Persons Service (OPS) on the prevalence, impact and actions taken in response to patient racism towards staff. Methods: A cross-sectional survey (Total N=47; Black and Minority Ethnic (BME) staff: N=32; White staff: N=15) of staff experiences

Introduction: The Centre for Perioperative Care recommends the assessment and documentation of delirium using a validated tool such as the 4-AT in older people undergoing surgery. Aim: This quality improvement project (QIP) aimed to improve the assessment and documentation of delirium in patients aged 65 and above following vascular surgery in a tertiary centre. Methods: Patients aged ≥65 years who had undergone vascular surgery were identified and data was collected with access to the electronic patient record system. Analysis was carried out using Microsoft Excel and SPSS. Following baseline

Introduction There is limited understanding of long-term delirium care after discharge from hospital for older people. A realist approach was used to investigate the contextual factors and mechanisms of care that influence recovery from delirium. Realist evaluation is fundamentally theory-driven. A preliminary programme theory was used as the foundation for theory testing and refinement, in order to develop the RecoverED intervention. Method Realist interviewing techniques were used to obtain real-world and lived experiences of delirium recovery and service use in the community for theory

Introduction Improvement project in response to several bereavement meetings with families reporting concerns with communication and care received during their loved ones’ end of life care (EOLC). Methods Retrospective review of 79 inpatients documentation who died between August 2021-March 2022 in comparison against the Royal College of Physicians National Care of the dying audit to identify targets for intervention. Survey of 22 members of ward staff between (January-March 23) including medical, nursing, and allied health professionals to understand confidence, clinical knowledge and

Background: Patients who experience a hip fracture have a high re-fracture risk. Prompt initiation of anti-osteoporosis treatment is therefore vital. Oral bisphosphonates are less well tolerated in some older people resulting in poor adherence. A single dose of IV zoledronate however, can be effective for up to 3 years and is shown to reduce fracture rate by 35% (Gregson, Age and Ageing, Vol 51, 2022). Aim: To increase use of IV zoledronate post hip fracture in Salford Royal Hospital Local barriers: a trust guideline advising a 7 week vitamin D loading regime means inpatient IV zoledronate

Introduction: As we strive to generate more geriatricians we must understand the journey of the training programme. Whilst information is available from the RCP census and BGS workforce survey this study will compliment that data and obtain a broader picture. A similar survey was last undertaken by the BGS in 2019 and since that time much has changed, from a pandemic to the first published NHS Long term workforce plan. Method: TPDs were contacted directly by the BGS VP for workforce at the geriatric medicine specialty advisory committee and invited to complete an electronic survey. The survey

Introduction Symptoms of depression and anxiety, with and without dementia, are common in older care home residents. It is postulated that that watching films can help residents to share emotions, enhance social connectedness and engage in reminiscence. As such, films can ameliorate depression and promote well-being. This scoping review summarises the evidence for the therapeutic benefits of film-based interventions in care homes. Methods Electronic databases MEDLINE, Embase, EMCare and CINAHL were searched for quantitative and qualitative studies in English including adults aged 65 years and

Introduction Despite the knowledge that oral anti-coagulation (OAC) is effective in secondary prevention of stroke, prescribing rates are low in frail older patients with atrial fibrillation (AF), dementia, and high fall risks. A joint decision-making approach between clinicians, patients and carers is needed to negotiate the risk-benefit balance. The aim of this participatory study was to engage with a group of older adults, their carers and healthcare professionals to identify key themes that will inform a planned qualitative study exploring frail older patients’ acceptance of and adherence

Introduction: Population is growing old worldwide and UK is no exception. Health service models designed to cater the needs of service users are under immense pressure due to the aging phenomenon. With unprecedented demand, their often low acuity, hence low priority and delayed conveyance to hospital and unavailability of services to address their needs due to delayed arrival; frail older patients often have to wait longer in emergency department (ED) to receive care in ED. Innovation and news models of care are therefore need of the hour to address this challenging situation. Methods: Quality

Background: Data are limited on whether the causes of Emergency Department (ED) attendance and clinical outcomes vary by frailty status. Methods: Using the Nationwide ED Sample, causes of attendance were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) of ED and overall mortality. Results: A total of 155,497,048 ED attendances were included, of which 125,809,960 (80.9%) had a low HFRS (<5), 27,205,257 (17.5%) had an intermediate HFRS (5-15) and 2,481,831 (1.6%) had a high HFRS (>15). The

Introduction Parkinson’s disease (PD) is the most common neurodegenerative movement disorder and is associated with significant disability. The prevalence of PD is rising and the literature demonstrates potential sex and race disparities in patient outcomes. There is a paucity of data about the demographic trends in PD-related mortality in the United States (US). This descriptive study aimed to report the national demographic trends in PD-related mortality over a 20-year period. Methods From January 1999 to December 2020, the US Centers for Disease Control and Prevention Wide-Ranging Online

Introduction : This study demonstrates how a network of geriatric medicine trainee representatives was established across the UK. The intention of the network was threefold: accurately represent the interests of trainees by gathering national feedback, develop a job description of deanery trainee representatives and create a community of practice between representatives. Method: Deanery trainee representatives were identified through TPDs then contacted to participate in an online questionnaire which also consented for whatsapp group invitation. Results: Deanery representatives were identified

Introduction Urinary incontinence significantly impacts the lives of older adults increasing their susceptibility to falls, social isolation and longterm care Intravesical Botulinum Toxin A (Botox) offers a well-established treatment for overactive bladders in women. In select centres, it can be administered under local anaesthetic, allowing access for frailer patients at higher risk from general anaesthetic and in whom anti-muscarinic therapies are best avoided. This project performed an analysis of geriatric patients who underwent intravesical Botox under local anaesthetic in an outpatient

Introduction The ongoing rise in prostate cancer rates and consequent prostatectomy have led to an increase in rates of male stress urinary incontinence. ATOMS is an adjustable sling requiring no manual input and suitable for frailer patients. We investigated the long term efficacy of the ATOMs in managing SUI and performed a subanalysis within the geriatric population (aged 75+). Method 69 men (mean: 70.2, range 50-81) underwent an ATOMS insertion between 2015-2019. Follow up data for up to 9 years were analysed (mean: 5.8, range 5-9 years). Out of the 69 men in the original cohort, 19 were

Introduction Transition is potentially a stressful incident to individuals as it requires major life adjustment. Older residents living in a nursing home consider it as their last place of life. When the older residents have to be relocated to a new nursing home, they inevitably face a significant transition due to their high dependency on the physical, psychological, and social needs. There is limited empirical evidence revealing the experiences of older residents who anticipate a transition from the existing nursing home to a new nursing home, thereby hampering our understanding of their

This Quality Improvement Project (QIP) addressed the pressing need for increased awareness of delirium among patients' relatives. With a 26% rise in the elderly population in Cambridgeshire, surpassing the 18.6% national average, the project provides crucial information to enhance patients’ relative's access to information about delirium, a condition affecting up to 50% of older hospitalised patients. This prospective QIP was conducted across seven Cambridge University Hospital (CUH) geriatric wards. Qualitative surveys determined delirium awareness, understanding, interest and perception of

Introduction Dementia with Lewy bodies (DLB) is the second most common form of dementia, however it can be difficult to recognise and is often misdiagnosed. Many cognitive, motor and psychiatric symptoms occur in the prodromal phase of DLB, years before clinical diagnosis. Delirium-onset DLB is one of three purported prodromal pathways by which DLB develops (McKeith et al., 2020). As delirium itself is an under-recognised clinical syndrome, this scoping review aimed to determine the epidemiology and clinical phenotype of delirium-onset DLB. Methods Electronic databases MEDLINE (ALL), Embase