Resources

Healthy ageing has become a global priority to add quality to our later years and reduce the morbidity associated with ageing. Entering older adulthood, however, increases the risk of frailty and sarcopenia — key factors driving age-related morbidity. Frailty is a multi-system impairment associated with increased vulnerability to stressors. Sarcopenia is the loss of muscle mass and function and is a major component of frailty. Skeletal muscle has a reduced response to stimuli such as protein intake and exercise with advancing age, driving the gradual loss in muscle mass seen in older adults. High protein diets, especially when paired with resistance exercise, can help to overcome this anabolic resistance and restore or maintain physical robustness. The commonly cited protein requirements for adults published by the Department of Health (DH) underestimate the needs of older adults. Other nutritional factors, such as weight loss and vitamin D status, also play important modulating roles in frailty and sarcopenia.

There are an increasing number of people being diagnosed with dementia. Dementia is a life-limiting condition for which there is currently no effective treatment or cure to alter its progressive course. UK dementia policy has tended to focus on living well with dementia and less so on dying well with dementia, and there is a consistent difficulty in recognising when a person with dementia enters the end-of-life phase. The disease trajectory of  dementia is noted as being unpredictable, especially when compared to those of other terminal conditions and, in addition, when there are other lifethreatening conditions comorbid to the dementia. This paper uses two anonymised case studies that consider dying with and dying from dementia respectively, and offers rationales to support better
recognition of dying for quality end-of-life care

Health care should aim to heal rather than harm. Sometimes traditional or routine practices which are not evidence-based can affect a person’s health and wellbeing. They may experience minor issues such as the adverse effects of a medicine, major issues such as  developing Clostridium difficile, or even death as a result of antimicrobial resistance (AMR). NHS hospital staff insert around two million urinary catheters each year (Shackley et al, 2017; NHS Digital, 2023). In some cases, antibiotic prophylaxis is given on insertion or removal of the catheter (Scarlato et al, 2017; Morris et al, 2023). Inappropriate urinary catheterisation and misuse of antibiotics expose individuals to a number of risks and increase the risk of antibiotic resistance. This paper examines the evidence base for antibiotic prophylaxis upon insertion and removal of urinary catheters. The author argues that a more holistic approach to care which reduces the routine use of indwelling catheters is required.

In 2024, the Alzheimer’s Society reported that one in three people born in the UK today will develop dementia in their lifetime. Its report shows that around a million people in the UK have a form of dementia. This is projected to rise to 1.4 million people by 2040. Alzheimer’s
disease and dementia are becoming a major burden on health and social care resources, as well as a financial and social cost to families who struggle to care for their loved ones. The report commissioned by the Alzheimer’s Society in 2024 revealed that dementia costs in the UK equal £42 billion per year. This is set to rise sharply to £90 billion by 2040. Here, Annette Duck, retired interstitial lung disease specialist nurse, gives a personal account of how she and her family were let down by health and social care services with regards to their father’s care and discusses the evidence and guidelines to see what might have helped and supported them to care for their father.

Caring for patients with wounds is part and parcel of daily community caseloads. With an ageing population and more complex community cases, frailty is inevitably becoming more of an issue. This should never be considered in isolation, but rather as part of a wider picture interrelating with other agerelated factors, such as ageing skin, increased susceptibility to skin tears, and other underlying health conditions that may complicate  wound healing.

Compression bandaging can present a challenge to healthcare professionals. Some clinicians may not have the necessary skills and training to safely and competently apply it, while others may be using it but not in accordance with the evidence base. As clinicians, it is our responsibility to make sure that our knowledge and skills are up to date so that we can  deliver evidence-based care to patients and do no harm (Abu-Baker et al, 2021). The NHS Long Term Plan emphasised the importance of placing the patient at the heart of their care with their experiences, needs and preferences considered when developing a care plan with them (NHS England, 2019).

Continence problems in children are more common than many people know — indeed, 1.5 million children in the UK are affected by bladder and bowel issues (Paediatric  Continence Forum [PCF], 2024).

These conditions are lifechanging for families, with children experiencing pain and discomfort, and wellbeing effects like missing out on schooling and socialising.

As a GP, I see a lot of people with dementia and their carers, and I also see those who are concerned that they may have dementia. These numbers have increased significantly since Covid, as people avoided seeing their GP and did not come forward if they had concerns.

The British Dermatological Nursing Group (BDNG) is a unique membership organisation, focused primarily, on offering accessible educational content for those working with skin.
The organisation has roughly 4000 members comprising a range of health disciplines and offers a variety of educational resources supporting those working in clinical practice for
a small fee of £20 annually.

Over 3.8 million people in the UK are living with chronic wounds — and how they are managed can shape a person’s quality of life, for better or worse (Mölnlycke Health Care, 2022). However, their management often falls low on the priority list, and the system pressures facing the NHS since the Covid-19 pandemic have exacerbated the problem. This means that patients are facing worsening outcomes through inadequate services — and are paying the price with their physical and mental health.