Category Archives: Blog

Could this be cancer’s magic bullet?

London – Have scientists found the great breakthrough for cancer therapy? The medical research world is abuzz this week with the news that an experimental treatment has banished blood cancer symptoms in 94 percent of patients.

What’s more, this success rate was seen in patients who were expected to live only months because such conventional cancer treatments as chemotherapy had failed to save them.

The results are being hailed as amazing and, if the trial’s success can be replicated on a much larger scale, could prove a pivotal moment in the history of cancer treatment.

Scientists at the Fred Hutchinson Cancer Research Centre in Seattle are claiming the medical victory after they treated several dozen patients with a cancer of the white blood cells called acute lymphoblastic leukaemia (ALL).

Also read: Living drug may wipe out cancer

Normally, only 40 percent of patients aged between 25 and 64 survive for five years after being diagnosed with ALL.

The rate is even lower among people aged 65 or older, at a dismal 15 percent, according to Cancer Research UK.

The American scientists’ new therapy involves genetically modifying a key weapon in the patients’ natural immune defence system, called T-cells.

These normally hunt and kill cells in our bodies that are infected with bacteria, or such viruses as cold and flu.

Crucially, the genetic modification effectively teaches the T-cells to recognise cancer cells as enemies to be destroyed.

As well as seeing the 94 percent success rate in ALL patients, when the researchers tried the treatment – called immunotherapy – on people with other blood cancers, they improved the condition of more than 80 percent of patients.

In more than half of those patients, the cancer appeared to have gone completely. As one of the lead investigators, oncologist Dr Stanley Riddell, says: “This is unprecedented in medicine, to be honest, to get response rates in this range in patients with these very advanced cancers.”

One further hope is that these “trained” T-cells will be able to stay in the body for years – acting as a form of vaccination against any returning cancers.

Another new immunotherapy study indicates that such modified T-cells can stay in the body for at least 14 years.

Professor Chiara Bonin says that her research at a Milan hospital demonstrates that it is possible to create cells that still “remember the cancer and are ready for when it comes back”.

Seasoned cancer experts are not ready to break out the champagne just yet, however, because the past two decades have seen many new therapies hailed as “magic bullets” for cancer subsequently not living up to their promise.

This is because they have cured far fewer patients than was first hoped or their side effects have proved too dreadful to inflict on patients.

In fact, one of the first scientists to use immunotherapy to fight cancer was New York surgeon William Coley in the 1890s.

He was inspired to do this by a patient with a rare cancer who staged an unexpected recovery after suffering a serious bacterial infection.

Coley believed this infection had provoked the patient’s immune system to attack anything that looked alien, including the cancer cells.

He then began vaccinating other cancer patients with bacteria, believing that, in a minority of cases, this spurred the immune system to destroy tumours.

His work was greeted with scepticism, however, and was then overtaken by the development of radiotherapy and chemotherapy as powerful cancer treatments – if not without their side-effects.

Now, William Coley’s ideas are being explored anew, but attempts to develop immunotherapy into a modern anti-cancer weapon have been dogged by the fact that tinkering with the human immune system is still fraught with danger.

These perils were highlighted in 2006, when six volunteers were admitted to Northwick Park Hospital in Middlesex after the disastrous trial of a drug that worked by modifying the immune system, and which was intended to treat such diseases as multiple sclerosis.

The six healthy young men’s immune systems began attacking their own bodies. They were rushed into intensive care with organ failure after experiencing serious reactions within hours of taking the drug.

The worst-affected lost his fingers and toes. What’s more, all the men were then told that they would be likely to develop cancers or auto-immune diseases as a result of their exposure to the drug.

Dr Riddell is open about the potential dangers of his newly-announced immunotherapy treatment: “There are reasons to be optimistic, there are reasons to be pessimistic.”

Indeed, during his trial, there were problems with some patients whose immune systems appear to have overreacted; 20 developed a condition called cytokine release syndrome.

Cytokines are messenger cells in the immune system that can go out of control when the system is overstimulated.

In turn, they can drive the immune system to overreact further, inflaming healthy cells throughout the body.

In Dr Riddell’s trials, the affected patients suffered symptoms of fever, dangerously plummeting blood pressure and nerve damage. Two of his patients died.

Dr Riddell believes, however, that lowering the dose of T-cells can reduce the risk of side effects.

There are other reasons why we should welcome such work with some caution, particularly since the results are very recent and there is a risk that the patients’ symptoms could reappear in future.

Indeed, cancers are notorious for returning months and even years after patients have been given the all-clear. This is not least because tumour cells can hide, dormant, deep in patients’ tissues to evade attack, and reactivate themselves later.

Professor Peter Openshaw, British Society for Immunology president, says that Dr Riddell’s research is “exciting” but believes we must be patient as its findings are explored further.

Intriguingly, he believes that, although this latest research used immunotherapy as a last-ditch treatment, it may best be used early on, just after patients have been diagnosed with their cancer.

The professor has also warned that immunotherapy may not work on many types of cancer, because the tumour cells they produce do not carry consistent identifying markers that the genetically modified T-cells can recognise and then attack.

Instead, the cells are able to change and adapt to threats.

“Such cancers can evade and escape immunotherapy by evolving their cells very quickly,” says Professor Openshaw.

Certainly, the tests causing so much excitement so far have targeted only certain blood cancers, and the researchers acknowledge they need to see how long their patients remain in remission.

It will also take at least five years to get this treatment into standard use.

Dr Riddell agrees immunotherapy requires much further development and that, even then, it will not be a panacea for every cancer. Nevertheless, his excitement is undimmed.

“Much like chemotherapy and radiotherapy, it’s not going to be a save-all,” he says. “However, I think immunotherapy has finally made it to becoming a pillar of cancer therapy.”

And for that, we may be both hopeful and grateful.

Source The Independent

Cancer ‘vaccine’ that remembers disease and fights it years later is developed by scientists

Researchers engineer immune cells so they boost body’s natural defences to fight tumours and stand guard for lifetime – acting effectively like vaccine

Scientists say it is like having a “living drug”, which is constantly vigilant to the return of cancer and quickly removes it from the body.

A new study, presented at the American Association for the Advancement of Science annual meeting in Washington, has proven for the first time that engineered “memory T-cells” can persist in the body for at least 14 years.

Professor Chiara Bonini, a haematologist at San Raffaele Scientific Institute and Vita e Salute San Raffaele University in Milan, said: “T-cells are a living drug, and in particular they have the potential to persist in our body for our whole lives.

“Imagine when you are given a vaccine as a kid and you are protected against flu or whatever for all of your life. Why is that? It’s because when a T-cell encounters the antigen and gets activated, it kills the pathogen but also persists as a memory cell.

“Imagine translating this to cancer immunotherapy, to have memory T-cells that remember the cancer and are ready for when it comes back.”

In a trial at a Milan hospital, ten patients who had bone marrow transplants were also given immune-boosting therapy which included the memory T-cells. They were found to be there 14 years later.

Immunotherapies, which harness the body’s own immune system, look set to replace cell-damaging chemotherapies. But one of the biggest challenges is to make these changes last long enough that the cancer cannot come back.

The Milan study proved for the first time scientists have shown that these cells can survive in the body well beyond the original cancer treatment.

Prof Bonini and colleagues are now working on a new wave of immune cells that can use sensor molecules known as antigen receptors to track down and wipe out a wide variety of types of cancer. When the cells are combined with the memory cells it should produce a treatment which effectively vaccinates the body against cancer.

“When a T-cell encounters the antigen and gets activated, it kills the pathogen but also persists as a memory cell,” she said. “Some of these memory T-cells will persist through the entire life of the organism, and so if you encounter the same pathogen – say if the same strain of flu comes back ten years later – then you have memory T cells that remember it from ten years earlier and kill it quickly so you don’t even know you’re infected.”

Daniel Davis, professor of immunology at the University of Manchester, said it was an “important advance” in cancer treatment.

“The implication is that infusing genetically modified versions of these particular T-cells, the stem memory T-cells, could provide a long-lasting immune response against a person’s cancer,” he said.

“Immunotherapy has great potential to revolutionise cancer treatments and this study shows which type of T-cells might be especially useful to manipulate for long-lasting protection.

“This research area is hot – no question about that. Our detailed knowledge of T-cells is paying off here with important new ideas for tackling cancer.”

In a separate presentation at the AAAS, a team of US scientists showed that their T-cell immunotherapy treatment for leaukaemia had an “unprecedented” success rate of 94 per cent in patients who had been given only months to live.

US scientists said they had achieved “extraordinary” results in early clinical trials.

Stanley Riddell, of the Fred Hutchinson Cancer Research Centre in Seattle, said balancing the different types of immune cells and then equipping them with cancer-sensing molecules had saved the lives of leukaemia patients for whom all other treatments had failed.

His team treated 26 patients whose acute lymphoblastic leukaemia was so advanced they had only two to five months to live. After 18 months, 24 of the patients were in complete remission.

“These are in patients that have failed everything,” Professor Riddell said. “This is extraordinary. This is unprecedented in medicine to be honest, to get response rates in this range from very advanced patients.”

Source The Telegraph

Covert medication to residents guidance

Care homes in Scotland have been provided with fresh guidance on giving residents medication covertly when they lack the capacity to consent but are refusing treatment.

The Mental Welfare Commission for Scotland’s revised guidance is designed to address rising use of covert medication in care homes and a lack of clarity about the legal basis for giving it. In 2012, 1.6% of Scotland’s 37,411 care home residents were given covert medication, up from 1.1% in 2010.

Covert medication involves administering medicines in disguised form, for example in food and drink, where a person is refusing treatment necessary for their physical or mental health.

Click here for the covert medication Care Plan.

Mental capacity

The guidance makes clear that it should only ever be considered when the individual has been found to lack capacity to consent to the treatment because of a mental disorder, Under the Adults with Incapacity Act (Scotland) 2000, treatment by force can only be used in an emergency. In its guidance, the commission said that it did not see covert medication as involving treatment by force, meaning that it can be used under the general provisions of the legislation.

Individuals are presumed to have capacity and should be supported to take decisions as far as possible, through information and explanations and means such as communication aids, speech and language therapy or psychological support.

“Covert medication is no substitute for explanation and education,” it says. “It should only be considered if impaired intellectual function makes this impossible.”

A medical or other health professional must have assessed the person as lacking capacity to consent to the treatment in question and issued a certificate of incapacity, under section 47 of the Act, specifying the treatment that should be given. The certificate can last for up to a year. Where the certificate is accompanied by a treatment plan, this should cover the use of covert medication, where this is deemed necessary.

The professional with primary responsibility for the individual’s medical treatment is responsible for deciding whether covert medication should be used. Before doing so, they must consider several factors.

Benefit and risk

Firstly, they must consider if the treatment is necessary for the individual, and the benefit must be sufficient to outweigh the risks of giving medication covertly. These include the risk that the individual will taste the medication in their food and drink, damaging their relationship with staff and potentially leading them to refuse food or drink.

Covert medication can also increase risks to safety and a risk-benefit analysis must be carried out before it is issued. For example, if medicine is crushed, this will generally mean it will be given outside the terms of its licence. In particular, slow-releasing or enteric-coated must never be crushed as this could be dangerous for the individual. Before administering the medication covertly, documented advice must be obtained from a pharmacist on doing this safely. Care staff must know how to administer the medication and there must be appropriate supervision available for them to do so.

Minimum restriction of freedom

Under the Adults with Incapacity Act 2000, interventions must be the least restrictive of the individual’s freedom, to achieve the desired benefit. Practitioners must question whether covert medication is really the least restrictive option. The guidance also warns that, in some cases, covert medication could be seen as degrading treatment, in breach of Article 3 of the European Convention on Human Rights.

Past and present wishes

Under the Adults with Incapacity Act, interventions must take account of the individual’s past and present wishes. Practitioners must inquire into why the person is refusing medication. It could be that they no longer wish to receive treatment or have never been in favour of taking medication.

Consult those closest to the person

Relatives or friends must be consulted about the person’s past statements or wishes on the subject. But those who know the person best will also be best placed to suggest how the person may be encouraged to take the medication without disguise. If covert medication is deemed necessary, they will be able to advise on the best way to disguise it.

Where there are no friends or relatives to consult, the guidance advises providing the individual with an independent advocate before covert medication is issued. The relevant local authority should be informed in these cases, as they may consider that a welfare guardian should be appointed by the courts to take decisions on the person’s behalf.

Record and review

The guidance also states that any use of covert medication must be recorded, and kept under regular review, with timescales based on the individual’s circumstances. If any additional medication is required, this should not just be administered covertly but should be considered as a fresh case and justified in the same way.

Click here for the Covert Administration of Medication Review.

Dine with Dignity – Fantastic New Product

Dine with Dignity has created an adult bib which can make dining stress free, for people who have difficulty eating, or people with a disability and where spillages can be a problem.

Eating, and the enjoyment of food and drink, is and always should be one of life’s pleasures.

However, for some elderly people, or people with a disability, it can become a daily challenge.

Dine with Dignity has been created to meet a real need in the care sector.

To purchase a Dine with Dignity Apron click here to visit the Buy Now page.

Many medical conditions can cause difficulty with the physical act of eating, cutting food into bite-sized pieces, holding cutlery, and successfully getting food from a plate into the mouth.

Drinking can be equally as challenging. It is so important to ensure that the experience of eating and drinking is a pleasurable one and that all issues are addressed in as dignified way as possible.

Take the stress from dining

  • Protect clothing from spillages
  • Save carers time
  • The adult bibs are made of 6oz double layer polycotton
  • Absorbent
  • Washable

Dehydration in The Elderly

Dehydration

Older people are at increased risk of dehydration for a variety of reasons. Unfortunately, however, it can be especially difficult to spot the signs of dehydration in the elderly.

Click here for the dehydration Care Plan.

Symptoms of dehydration may overlap with those of other conditions or be shrugged off simply as old age, leading to late diagnosis and risk of serious complications.

Our bodies are made up of about 70% water and this fluid is essential for controlling body temperature, flushing out toxins, and keeping the blood flowing freely.

Without adequate water people are at a higher risk of urinary tract infections, heart problems due to increased blood viscosity, heat stroke, and even joint aches and pains caused by toxic build-up and increased inflammation.

As many older people are already living with heart disease, bladder problems, and weakened immune systems, the risks posed by dehydration are even greater.

A significant loss of total body water content can prove fatal but it may be hard to spot the signs of dehydration in the elderly, requiring careful monitoring and effective communication.

There is no single, declarative sign of dehydration, especially in the elderly, because a loss of total body water content affects a great many organs and systems.

It appears that older adults are more sensitive to the effects of stress on fluid homeostasis, particularly because of poorer function of the renal system, gastrointestinal function and so forth.

Elderly also suffer more severe effects of dehydration in many cases because of existing age-related weaknesses in certain systems.

Signs of Dehydration

One of the first things to look out for that might suggest dehydration is discoloration of the urine.

Some medications can affect urine colour but for most people it should be clear or pale yellow.

Dark urine can be a sign of urinary tract infection and/or dehydration causing waste products to become concentrated in urine.

Decreased urine output is also a sign of dehydration and so nursing staff, relatives, friends, or the patient themselves should monitor catheter output or record the frequency of bathroom visits as well as fluid intake.

One major sign of dehydration is a dry mouth with reduced saliva production and subsequent problems swallowing tablets or food.

The elderly may also develop a dry cough or tickly throat, with visibly parched lips.

Elderly who are dehydrated may become more demanding and any urgent and uncharacteristic demands for specific foods or beverages should be carefully assessed as this may be a sign that the body is making every attempt to increase fluid intake.

Elderly people may also become confused, fatigued, and sluggish when dehydrated, which can be mistaken for symptoms of dementia or general old age.

Because dehydration means that the heart has to work harder to pump a reduced volume of thicker blood around, they may become out of breath and tired more quickly than usual.

A reduced volume of blood also means that blood is directed towards essential organs and away from the skin and muscles.

This can cause confusion, a bluish discoloration to the skin, increased body temperature as sweating is reduced and the body is unable to cool down, and even muscle cramps and joint pain as joint lubrication is reduced.  

Headaches are another symptom of dehydration in the elderly, caused by an inability to cope with high temperatures, as well as by reduced ability to flush out toxic metabolites and to deliver adequate oxygen and nutrients to the brain.

Simple decisions may become difficult, which can lead to the person taking risks and having accidents.

There may be short-term memory loss, confusion, mental fogginess, and even mood disturbances.

Preventing Dehydration

The traditional recommendations are to drink the equivalent of eight or more large glasses of water every day to stay adequately hydrated. 

Thirst is usually the best way to determine necessary fluid intake, but extremely hot temperatures, diuretic medications, and certain medical conditions may increase a person’s need for water, and some people may not be able to address their thirst.

Tea and coffee are now considered as effective at maintaining hydration as water itself, but the majority of water intake still comes from the food we eat. 

As such, dehydration is more of an issue for older people who take in fewer calories and, therefore, less fluid through their diet. 
Water found in food is usually accompanied by beneficial nutrients, including electrolytes, which are essential for the maintenance of proper water balance and cellular signalling. 
Simply drinking a lot of water may not be sufficient to correct dehydration, especially if potassium, magnesium, and sodium have been lost through sweat and/or urine.

The elderly should have easy access to water throughout the day and carers should encourage hydration through recording fluid intake.

Meals should not be rushed, to give the elderly time to drink water at leisure and eat at their own pace. 

Treating Dehydration

Elderly who are dehydrated require lost fluids to be replaced.

It is important that with all elderly there is an assessment of their fluid and dietary intake, but it is absolutely vital that all elderly with dementia have an assessment for fluid and dietary intake.
All risks for dehydration should be considered and addressed where possible and a monthly review of risk should be carried out.
Dehydration can be rectified very easily and in a care setting either Care Home or Hospital setting dehydration should be prevented by good nursing care.
Too many elderly people are having to experience the upset of a preventable hospital admission. 
For an elderly person with dementia the experience can be really frightening.
We have recently developed a dehydration risk assessment tool to ensure carers and nurses address the issue in an evidence based professional manner.

Click here for the dehydration Risk Assessment.

Dementia -What Every Carer Should Experience to Give Them Understanding

What do people with dementia hear, see and feel?

Every person is unique and the way dementia affects them is different.


Physical Changes

A recent training session delivered by the nursing department of the West of Scotland University, gave me a real insight as to what it was like. Absolutely terrifying, frustrating, and exhausting!


Difficulty with dexterity, clumsy, arthritic

We had to put on latex gloves and had our fingers taped together to give us an idea of what it can be like to have arthritis and changes in dexterity.


Visual changes, macular degeneration, glaucoma, cataracts

We had to put on goggles which really changed the way you could see.


Auditory noise, incessant jabbering

We had to put on earphones which had a constant jabbering noise sound resonating through them.

It was impossible to function with all the noise and difficulties. The noise was particularly distracting.

The noise was so irritating and annoying and it was totally impossible to concentrate.

All the staff who took part in the training were upset by how little they understood what living with dementia was like.


This video shows how difficult it can be to live with dementia.  

 

All carers would care differently and much more sympathetically if they had this training.

It would give them a real understanding of exactly what a person with dementia experiences.

Click here for  our Nursing Care Plans for a person with Dementia

Music

We have always been tried to be innovative in our approach to caring for the elderly.

Music for everyone can be extremely therapeutic whether it be calming, or uplifting.

YouTube has a wonderful video showing the effect listening to music on an ipod has on a person with dementia.

With the help of families and relatives we have uploaded music personal to individual residents and we have seen incredible improvements in people with dementia.

It actually can be miraculous for some people, and can really improve their quality of life in a way you would not think possible.

What effect does music have on a person with dementia?

  • It can quieten the incessant noise 
  • It can bring back memories of happy times and feelings 
  • It can take up a persons attention for a time
  • It can stop for a time anxiety and worry 
Whatever it actually does, it really helps some people.



Aromatherapy

Massage has been used for centuries to heal, relax, revitalise and comfort. 

Aromatherapy is the practice of using the natural oils extracted from flowers, bark, stems, leaves, roots or other parts of a plant to enhance psychological and physical well-being.

The inhaled aroma from these “essential” oils is widely believed to stimulate brain function. Aromatherapy can provide pain relief, mood enhancement, and increased cognitive function.

Aromatherapy is one of the most successful alternative therapies for some elderly people with dementia.  
 
What is remarkable is that all of the treatments resulted in significant benefit, including, in most instances, reductions in agitation, sleeplessness, wandering, and unsociable behaviour.

For many elderly people the physical touch during massage, and the one to one attention is comforting and calming.

Click here to read the full report published by Alzheimer’s Society Research on Aromatherapy for the treatment of Alzheimer’s disease.

Dementia patients’ rages may be entirely due to pain

The Mail Online reported on a really relevant and very important article on dementia.

“Ann Pascoe’s husband Andrew had always been a gentle, mild-mannered man. So when he was diagnosed with dementia seven years ago, she expected him to be forgetful and become more dependent – what she was not ready for were his aggressive outbursts.”

‘It was incredibly upsetting and I was permanently walking on eggshells but thought that this must just be part of the dementia, I was getting to the stage where I felt I couldn’t cope any more’ she said.

After andrew developed dementia, from time to time he would get very agitated - and even throw things

Then, last August, Andrew had fainted at the bus stop in the village near where the couple live in Helmsdale, Scotland.

On examination the doctor diagnosed Andrew with neuropathic pain in his legs and he asked if Ann would keep a ‘pain diary’ for two weeks.

Ann’s diary showed that Andrew was in considerable pain a lot of the time and the doctor prescribed him Gabapentin, an epilepsy drug which interrupts the transmission of pain signals in the brain.

According to a recent review in the journal Clinical Intervention In Ageing the major cause of aggression and agitation is untreated pain, however many patients are given inappropriate sedation.

800,000 people in this country have dementia and they tend to be older and therefore more prone to aches and pains.

‘It is vitally important that care professionals have the tools and training to meet the complex needs of people with dementia.’

Can you imagine what it would be like to be in pain but not have the ability to express yourself?

Nurses and carers need to really observe and assess if a person with dementia is in pain.

Our Pain Care Plan incorporates a recognised and effective assessment tool for assessing pain in a person who cannot tell you they are in pain. Click here to buy it.

Where it is impossible to assess the patient or residents level of pain, due to their condition, would it not be a lesser evil to try pain relief?

What you think?

To read the full article Click here Mail Online

Detecting when a person with dementia is suffering from pain is so important

In an excellent article recently in the Guardian, Jo James, dementia lead at the Imperial College Healthcare Trust and stalwart champion of John’s Campaign from the start, told the story about her own mother’s unidentified pain in hospital.
 
Her mother had advanced dementia when she sustained facial injuries after a fall.

She had 60 stitches to her face, a broken cheekbone and nose and the loss of most of her front teeth.

She had been given nothing for pain. The nurse said: “Don’t worry. She won’t be in any pain.”

The clinicians looking after Jo’s mother simply had not thought about pain and she could not tell them.

Research shows that people with dementia receive significantly less pain relief than others when they are in hospital.

The thought of someone being in terrible pain with no hope of respite from it is hard to imagine, and combined with all the other challenges facing a person with dementia, it also seems tremendously unfair.

However, the solution is simple and requires no specialist knowledge or training.
 
Simply being aware of the possibility of pain and flagging it up so that the person can be given some relief is all that is required and is something that we can all do.

Nurses and doctors need to become much more sensitive to the fact that the person with dementia may be in pain.

If they had any kind of past physical issue or condition such as arthritis, back pain, shoulder pain, or any aches and pains, they will most likely continue to experience that issue as they develop dementia.

Their physical issues don’t disappear.

They may not be able to communicate the fact they are in pain.

Our approach is to carry out an assessment which incorporates all potential physical signs and the past history of any painful condition.

This has been really successful.

Recently a lovely gentleman was admitted to our Care Home. He was admitted from a psychiatric assessment ward.

On admission he was prescribed numerous, medications including antipsychotic drugs, sedatives and tranquilisers.

His behaviour was extremely agitated and anxious most of the time.

He appeared to be very frustrated, and could not communicate verbally, and it was not clear at all that he was in pain.
 
He was prescribed an analgesic as required in the hospital but he did not receive it regularly.

We asked the doctor if we could try giving the pain relief regularly for a two week period to see if this helped him, as the gentleman was unable to communicate he was in pain. He agreed.

The difference was amazing. His wife could not believe the transformation in her husband. He is now calm, content, and at peace with himself and others.

He enjoys his food more, he participates in most activities, and he smiles and engages with the staff and his family more than he has done since his disease was diagnosed.

He also is speaking and communicating much more than he did, previously.

His quality of life has improved tremendously.

It makes complete sense especially if the person with dementia is elderly.

Their joints, bones tendons and muscles suffer wear and tear, and arthritis can set in.

To try analgesics in the assessment period is a sensible approach.

Too often when residents appear agitated, anxious or aggressive the only remedy appears to be sedation or antipsychotics.

This should not always be the case.

Click here for an excellent comprehensive pain assessment tool for people with dementia or who cannot communicate that they are in pain.

Legalising Assisted Dying Could Be Catastrophic for the Elderly

Legalising assisted death may pressurise the ill and disabled into believing it may be the correct route to take to relieve their families and loved ones of the burden of looking after them. 
The assisted dying bill would allow adults of sound mind, with six months to live, the right to end their life at a time of their choosing.

Lord Tebbit warned that “the bill would create financial incentives to end the lives of the frail, the handicapped the ill and the elderly and be a breeding ground for vultures, both individual and corporate.”

“the bill would put great pressure on the elderly, the sick and the disabled to do the decent thing and cease to be a burden on others. Those who care for such people are all too familiar with the moments of black despair that prompt those words, ‘I would be better off dead, so that you could get on with your life’.”   

Baroness Finlay opposing the bill stated “lets not forget that Dr Shipman’s 176 cremations were all countersigned by a second doctor”

Everyone fears the onset of many illnesses and diseases, but one of the most feared is dementia or Alzheimer’s disease.

To many people, dementia can be seen as one of the most undignified disease processes and one of the most debilitating illnesses to be experienced, both by the person with dementia and also the relatives and family members who care for the person.

Dementia can impact so forcibly on every aspect of a person’s life but is he or she any less a person? They are the person they have always been, but with a condition which is possibly going to worsen, and which may change their lives. 
It is my belief that health care professionals should consistently try to improve the quality of life of any person with any illness or condition. 

The Liverpool Care Pathway

The Liverpool Care Pathway has to an extent been a disaster, and almost a death sentence for patients. Once started on this pathway the individual may have been be denied fluids and food. 
In the past nurses and carers have cared for patients at the end of their life in a dignified and professional manner, and decisions about a person’s care and his or her treatment were made on a day to day basis depending on the patient and taking the views of the family into account.
 
Recently government ministers promised that loved ones must be ‘involved in decisions’ in NHS hospitals to ensure the abuses and ‘tick-box’ culture created by the discredited Liverpool Care Pathway never happen again.
And hospital managers or doctors who try to cover up the circumstances of a patient’s death will be subject to criminal prosecutions and heavy fines in court.

The radical rights for families are part of a new protection package for the dying, that ministers say will mean an end to the ‘protocols and processes’ that led to the Liverpool Care Pathway scandal.

There is today a real danger of health professionals trying to pigeon hole the care of people, believing that to do so may be in the best interests of a patient when it is not.

Do Not Attempt Resuscitation(DNAR)

 
Do not attempt resuscitation faces similar issues, which need to be addressed and managed properly with person centred care and the interests and well being of the patient being the foremost consideration.      
I have had the privilege to care for many very intelligent elderly people with dementia.

I have been part of a team responsible for improving their quality of life.

People can live well with many diseases, but there is a clear danger that some people’s perception of certain illnesses such as dementia may lead that person to presume that all people with this disease might wish to die.

Legalising assisted death could very possibly lead to legalised euthanasia and the death of many with a variety of diseases and illnesses.  

Mr Hunt has not commented publicly on his position, but in a letter to a constituent seen by the Mail, the Health Secretary wrote: ‘I am concerned it devalues the life of people with permanent disabilities and could inadvertently put pressure on people who worry they are a ‘burden’ to their families (including incidentally 48 per cent of people with dementia).

Winterbourne said “I do not want our trusted NHS to turn from being the National Health Service into the National Death Service”.

Something to consider carefully?

 

Nurses to follow ‘moral compass’ on poor standards

As reported in the Nursing Times, Liz Redfern, a former deputy chief nursing officer who joined the NHS as a cadet nurse in 1970, was speaking after receiving an honorary doctorate from the University of Brighton.

    “Some of my proudest moments are when I have spoken up against poor practice whatever the consequences for me”

    Liz Redfern

“There will have been times already that have made you uncomfortable when you have seen practice that fell short of your own personal standards,” she told an audience of newly-graduating nurses.

“You know what you are witnessing is wrong – either technically or morally – and sometimes you will have spoken out and sometimes not,” she said.

People should not be nurses if they do not have a love of the job.

Nursing is a wonderful profession but it has changed drastically over the past 30 years and if the news headlines are anything to go by the changes are not for the better.

More and more cases of neglect and abuse.

Nursing used to be about patient care and supervision of care staff and the delivery of care.

Nursing is now very much a written paper trail of evidence and a disproportionate amount of time is spent ensuring paperwork is kept up to date.

The delivery of care and supervision of staff is now the lesser part of the job but is it not the most important?

Of course it is!

Excellent patient care is the goal for the CQC, NHS, UK government and it is very much the goal for nurses but with poor staffing levels and so much paperwork, how is it possible to do everything? 

An elderly person can have anything from 5 to 15 nursing care plans for a multitude of health and physical issues and numerous assessments to be completed.  

These care plans are basically in depth essays of each issue and how in agreement with the person the nurse or carer is going to deliver the care specific to that issue. Time consuming!

Click here to check out our Nursing Care Management Solution

Helping nurses and carers to write excellent detailed, person centred, Nursing Care Plans quickly and easily.