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Conference - Assessment & Management of the Frail Older Person

Assessment & Management of the Frail Older Person

Date: 15/10/2020


Duration: 1 Day
Start Time: 09:00 - End Time: 16:00
CPD Hours: 7

Conference Overview

A busy programme covering integrated care, establishing teams, drug management and polypharmacy plus care coordination and service delivery. The intention is for health professionals attending to be further equipped with: practical evidence, examples, experience, creativity and innovation by hearing from colleagues from across the UK and healthcare professionals will be able to take these ideas back and implement them in their own places of work. One of the main aims of this conference is to share ideas and to network. 

 

Attended by nurses, allied health professionals, medics, social care professionals, academics, senior managers, department heads, Government leads and national organisations who have an interest in developing innovative frail older person care.

Conference Content

CHAIR: Angela Kydd, Clinical Professor in Nursing, School of Nursing and Midwifery, Robert Gordon University and NHS Grampian, Aberdeen

 

Integrated Multi-agency Pathways - providing truly integrated person focused care and support for frail older people

  • The power of system-wide working to deliver seamless care for frail, older people in their own communities
  • Community Integrated Network teams (INTs) aligned to 18 Primary Care Networks (PCNs) utilising multi-disciplinary teams working to prevent hospital admissions and facilitate discharges
  • The Integrated Care Bureau (ICB) as a conduit to the community services, streamlining discharge processes for people with complex needs and making sure people receive the right care, in the right place at the right time (getting it right first time- GIRFT)
  • Development of exceptional care and support in a community setting to aid recovery and return to independence
  • Next steps - a new model of care - the Locality Acute and Reactive Services (LARCS) – to enhance service user experience by providing comprehensive multidisciplinary geriatric assessments within our new Locality Hubs to avoid a potential hospital admission

Cathy Daffada, Access and Flow Manager and Jenny Theed, Director of Operations, Sirona care and health, Bristol

 

Establishing an Advanced Nurse Practitioner (ANP) team in the management of older adults with frailty in the acute hospital setting

  • How our ANP team established the service in three years across two acute hospital sites
  • Managing the care of the high-level frailty patient, including planning and coordinating discharge
  • Impact on the patients we case-manage - robust discharge planning; prognostication and advanced care planning discussions; medicines review and management; optimisation of frailty and re-admission prevention
  • Challenges and evolution in delivering a frailty-focused service and a look at the future

Jeff Ting, Advanced Nurse Practitioner and Debi White, Advanced Nurse Practitioner, Care of the Elderly, University Hospitals Coventry & Warwickshire NHS Trust

 

Integrated Care providing Comprehensive Geriatric Assessment (CGA) makes a difference to length of stay in frailty

  • The Integrated Care of Older People (iCOP) service - a fully integrated multidisciplinary team that supports older people living with frailty
  • How the iCOP team identify people aged >75 years admitted with a frailty syndrome
  • Early intervention, discharge planning and support with the transition of care to wards
  • Summary of findings and results

Emma Lacey, Advanced Nurse Practitioner and Lorna Rowe, Physician Associate, Swansea Bay University Health Board

 

Can introducing a pharmacist in clinic help tackle polypharmacy and poor adherence?

The Kings Fund (2013) linked polypharmacy (≥ 5 medications) to increased re-attendance and re-admission to hospital and prolonged inpatient stays due to adverse drug reactions, non-adherence and drug interactions

  • A pharmacist did previously not see Elderly patients in the Triage Rapid Early Assessment Team (TREAT) outpatient clinics
  • We hypothesised if a pharmacist reviewed patients in addition to a doctor, they could further reduce polypharmacy and address medication adherence concerns
  • An average of two medications were reduced per patient with direct savings and indirect cost savings per patient, based on potential prevention of bed stays
  • Introduction of pharmacy led outpatient clinic service can reduce costs and improve patient care significantly

Sameer Jiwani, Triage Rapid Early Assessment Team (TREAT) Pharmacist and Myra Hernandez, Lead TREAT Nurse, Royal Free London NHS Foundation Trust

 

Medicines management and patient monitoring - The Adverse Drug Reaction (ADRe) Profile

  • Excess dose-related mortality, incidence of strokes, Parkinsonism and sedation, and reduced survival amongst service users prescribed mental health medicines are concerns
  • ADRe addresses this problem by ensuring:

    - The presence of signs and symptoms relating to ADRs is documented and reaches reviewers, even when the   patient is non-verbal and the reviewer is short of time

    - Patients’ medicines are reviewed in relation to their current problems
    - Problems are identified and treated before they escalate - Doses are optimised

Sue Jordan, Professor, College of Human and Health Sciences, Swansea University

 

Adverse outcomes associated with prescribing anticholinergic medicines in frailty – What do we actually know?

It is well established that the exposure to anticholinergic medicines in older people is associated with adverse health outcomes, such as physical dysfunction, cognitive dysfunction, hospitalisation and even death

  • People living with frailty are at greater risk of adverse health outcomes due to physiological changes and the failure of homeostasis, and it is believed they are more susceptible to the adverse effects of medicines
  • Focusing resources on routine identification of frailty, with primary care clinicians contractually obliged to target the most vulnerable for medication reviews. A view to deprescribing potentially inappropriate medicines (PIMs) such as anticholinergics, to mitigate risks
  • Associations with anticholinergic prescribing and adverse outcomes in older people specifically living with frailty, and whether frailty severity modifies such associations
  • Findings of a recent systematic review and the results of patient data analyses

David Mehdizadeh, Pharmacist & PhD student, National Institute for Health Research (NIHR), Yorkshire and Humber Patient Safety Translational Research Centre

 

Tackling the potential harm of polypharmacy in older people living with frailty

  • Impact of polypharmacy on frailty
  • Medications most likely to cause problems in frailty
  • Patient-centred medication review and appropriate deprescribing
  • Case study of polypharmacy and frailty

Jayne Agnew, Consultant Pharmacist for Older People, Southern Health and Social Care Trust and Paula Crawford, Consultant Pharmacist for Older People, Belfast Health and Social Care Trust

 

Care coordination in the elderly within Primary Care

  • Our team and the current patient group all patients highlighted as having complex needs, frailty, frequent hospital attendees, new or current palliative diagnoses
  • Completing full health assessments along with linking patients in with local social groups and our own groups, such as gardening in the local health centre
  • Early referral to areas such as social services, occupational therapy and physiotherapy, falls assessment and referral to local care groups, day centres or memory clinic
  • Identifying patients for fine tuning of care to an individual basis

Beth Jones, Care Coordination Lead and Sophie Nash, Specialist Community Nurse, Community Care Collaborative, Wrexham

 

A comparison of two methods of delivering an acute hospital Frailty Assessment service

  • Comparison of two methods: An allocated day unit versus ‘front door’ working in the Emergency Department (ED)
  • Collaborative multi-disciplinary team working to achieve efficient and timely completion of a Comprehensive Geriatric Assessment (CGA)
  • ‘Home First’ principles to enable prompt discharge planning and avoidance of Hospital-Acquired Functional Decline (HAFD)
  • Exploration of the benefits, outcomes and challenges

Emma Ferguson, Advanced Clinical Practitioner (Frailty Assessment) and Donna Kruckow, Trust Lead Nurse for Older People, Dementia and Frailty, Frailty Assessment Unit, Worcestershire Acute Hospitals NHS Trust

 

 

Conference Aims and Outcomes

HOW TO FIND THE VENUE

10-20 minute walk from Euston or Kings Cross

5 minutes walk from Russell Square tube station

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Exhibition opportunities

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Conference Enquiry

enquiries@mkupdate.co.uk

Professionals training professionals

M&K Update Ltd, The Old Bakery, St Johns Steet, Keswick, Cumbria, CAI2 5AS.

Tel: 017687 73030
Fax: 017687 81099
Email: enquiries@mkupdate.co.uk

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