SECOND OPINION:Research into caring for the elderly is alive and well, writes DES O'NEILL
WITH TWO flights a day from Dublin, Malaga is a popular tourist destination for the Irish. Last week, scattered among the casually dressed and relaxed passengers was a surprisingly large group of somewhat more formally dressed travellers, many carrying the bazooka-like tubes for academic posters. This was the healthily large contribution from Irish geriatricians to the annual scientific meeting of the European Union Geriatric Medicine Society, taking place in the smart surroundings of its Gehry-like Palacio de Congresos.
This congress took place last year in Dublin, and the opening ceremony then was graced with uplifting presentations by Séamus Heaney and Mary Robinson, as well as a short concert of music of mature creativity. Not only was it a wonderful showcase for Ireland and Irish researchers into ageing, but it allowed a huge number of Irish involved with the care of older people to get a taste of a major international conference – without travelling further than Dublin.
The good news from Malaga last week was that research and analysis of how best to provide care for the complex needs of older people is alive and well across Ireland, and can hold its own with the best of European research.
That such research is important is based on not only the many gaps in our knowledge about ageing, but also on the increasingly complex presentation of illness in later life.
“We are born copies, but die as originals” is an apt summary of the influence of nature and nurture on our increasing lifespan, and older people are much more likely to present with multiple illnesses and functional loss, such as reduced mobility or incontinence.
The good news is that advances in geriatric medicine (and related disciplines such as gerontological nursing and old age psychiatry) can provide more effective responses, as evidenced by an Irish-Scottish study this year, which established definitively that acute medical care in a geriatric medical unit reduce death and severe disability by 25 per cent compared with usual care.
This spirit of combining the academic with the practical was evident in the Irish contributions in Malaga. Particularly notable was the work on better systems for ensuring that older people get as few medications as possible, but don’t miss the ones that they need.
Dr Denis O’Mahony, a geriatrician at UCC and Cork University Hospital, is now recognised internationally as a trailblazer in this area, and in particular the Stopp-Start tool (Screening Tool of Older Person’s Prescriptions and Screening Tool to Alert doctors to Right Treatment). His presentation at Malaga was a model of academic endeavour, leavened with humour and practicality, and his group had two further major presentations on the topic.
Equally, Dr Shaun O’Keeffe (of NUIG and Merlin Park Hospital) is a European leader in research on delirium, an important but all too often neglected condition of ill older people. He is also widely regarded for his work in the more sophisticated ethical insights needed in the care of older people, and his keynote speech on this topic was very well received.
Other oral presentations included those of Dr Tara Coughlan, on behalf of a network of geriatricians and orthopaedic surgeons in Ireland developing a database of fractures and their care in Ireland, as well as presentations relating to elder abuse from the group based at Tallaght hospital (the most active centre for such research in Ireland), emerging data from a project examining the use of technology in improving quality of life for older people, better dental care in nursing homes, as well as a study of sophisticated scanning in Parkinson’s disease.
In addition, a wide range of Irish research was presented as posters, ranging from stroke and telemedicine, hip fractures, depression, frailty, aesthetic and cultural pursuits of those with stroke, and new treatments for blood thinning to prevent stroke.
While the world of academic conferences has been amusingly caricatured by David Lodge in his novel Small World, in reality taking part in such a meaningful way was immensely reassuring for the future of developing effective care for older people in Ireland – the demographic with proportionately the greatest need of healthcare.
In addition, at a time of doubt and confusion for the European Union, the synergy with a wider European family of researchers and clinicians on the best route to healthier ageing emphasises the benefits of a pan-European approach to the opportunities and challenges presented by an ageing Europe.
Prof Des O’Neill, a consultant in geriatric and stroke medicine, is the outgoing president of the European Union Geriatric Medicine Society