Deconditioning. Not measured. Not tracked. Not acted on. vm.tiktok.com/ZNR7o6prq/

In this cohort study, EHR-documented Advance Directives were associated with reduced potentially burdensome end-of-life care and a lower likelihood of in-hospital death. #geriatrics agsjournals.onlinelibrary.wi…

Things we often screen for on acute medical admission in older people: - Sepsis - VTE risk - Falls risk - Pressure ulcer risk - Nutritional status - Frailty But many places still mostly don't screen for: - Delirium BUT Delirium independently predicts mortality, prolonged admission, new institutionalisation, and incident dementia. It also causes a lot of suffering in patients and families, especially when not recognised and the diagnosis communicated.  There is a validated, free screening test that takes under 2 minutes, and it works. The 4AT. It's simple - see below. 🙏🙏🙏🙏🙏🙏 My hope is in a few years time we will look back on this era where it was okay to ignore delirium as horrifying.  We will wonder what we were thinking.  #dementia #delirium #falls #hospitalcare

What should you do instead? Diagnose UTI when there is a history of symptoms. Or when there is bacteria in the urine AND evidence of infection eg fever or blood test abnormalities AND no other more plausible source of infection

Urine dipsticks are commonly positive and don’t increase probability of bacteria in urine enough to be useful

Smelly or cloudy urine is NOT a reliable sign of infection in older people. It’s usually down to hydration or diet. Remember “The smell don’t tell”, and “The cloud is allowed.”

Up to half of older adults (and almost ALL with catheters) have bacteria living in their bladder without it causing an infection. This is called Asymptomatic Bacteriuria. It’s common, it’s harmless, and it doesn't need antibiotics

Want to know how to look after older people better on the ward? What to do in clinic? Community frailty team? New dates for 2026. 12 CPD points. £80 leedsfrailtyeducation.co.uk Checknout our videos on tiktok instagram and youtube too. @leedsfrailtyed

Does making an advanced care plan to die outside of hospital work? Is it worth it? @LeedsFrailtyEd

Capillary Refill Time in Sepsis—Searching for the Holy Grail jamanetwork.com/journals/jam…

👏👏👏

We do far too many blood tests. On our ward we’ve done 1400 fewer blood tests in the last 5 months compared to historical averages. Loads of patients get repeat LFTs that are normal, or as you point out repeat blood tests continuing to improve when everyone knows pt is well

When I did more acute care I’d come across approximately one patient a month with an MI who had no chest pain, but presented with delirium or falls. Do an ECG. Have a wide lens Most MIs are “atypical”

Correcting Hypernatraemia more quickly reduces mortality and LOS sciencedirect.com/science/ar…

Everything is awesome

The BGS is pleased that @NAOorguk has produced a report on primary and community healthcare for people living with frailty, and we welcomed the opportunity to contribute to the process. Sadly, the report makes for disheartening reading. bit.ly/48A636R

We need to come together to deliver better joined up care & neighbourhood health. Every system needs a frailty strategy. Identification & CGA at scale. Frailty Workforce & education. Check out @GeriSoc resources for age attuned integrated care, join the dots blueprint & much more

Pragmatic prescribing to reduce harm for older people with moderate to severe frailty | British Geriatrics Society …. and here it is!!! ⁦@GeriSoc⁩ 👏👏👏👏 bgs.org.uk/PragmaticPrescrib…