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Tuesday, 25 July 2017

The importance of tackling loneliness and social isolation

The importance of tackling loneliness and social isolation

An ageing and more transient population, and changes to the way we make social connections, are responsible for more lonely people than ever before.  Loneliness and social isolation can affect everyone older people are particularly vulnerable to social isolation and loneliness owing to loss of friends and family, mobility or income.  

According to the Office of Nation Statistics “Rates of chronic loneliness have remained steady since the 1940’s, with 6-13% of people over the age of 65 reporting they feel lonely ‘all or most of the time’.”  People from all age groups who report bad health are more likely to be socially isolated, and are more than 2.5 times more likely to report feeling lonely than those reporting good health.  However, this figure is likely to increase due to demographic developments such as Family dispersal and the ageing population.

Jo Cox MP for Batley & Spen (who was brutally murdered in June 2016) was an advocate for better service to tackle loneliness, she partnered with over 10 charities to expose evidence of loneliness across the UK.  Following her death MP’s and Friends have pledge to continue Jo Cox's campaign to tackle loneliness.

In March 2017, The Edith Ellen Foundation relaunched their Befriending Service, through the Legacy of Lady Bader (widow of the WW2 hero Sir Douglas Bader) – renamed Lady Bader Ambassadors in a bid to tackle Social Isolation in Care Homes and the Community.  The Lady Bader Ambassadors are a team of volunteers who enable those they befriend to rejoin groups of interest, provide a listening ear or reconnect to services and offer vital companionship and emotional support.  One-to-one befriending has been shown to reduce loneliness and has a modest but significant effect on depressive symptoms. Such regular one-to-one contact is particularly welcomed by people who are frail and housebound

As the UK’s population rapidly ages, the issue of acute loneliness and social isolation is one of the biggest challenges facing our society – and it must be addressed, for the sake of both the individuals concerned and the wider community. Health issues arising from loneliness and isolation add pressure on statutory health and social care services. By intervening in this issue, we can improve older people’s quality of life, while limiting dependence on more costly services.

In addition, in the UK the Samaritans can be contacted on 116 123.

Tackling loneliness and Social Isolation amongst our ageing population is challenge we cannot ignore – both at an individual level and as a wider community.

This will help to improve older people’s quality of life and reduce their reliance on more costly health and social care services.


Friday, 21 July 2017

Rashes in Older People

Skin changes are one of the most visible and significant signs of ageing and help to determine a person's age. Features include wrinkles, sagging and paper-thin skin, vulnerable to damage.

Prevention of skin breakdown in elderly patients can be crucial in preventing skin disease and morbidity, such as irritant dermatitis or infection

Older skin is more vulnerable to a number of dermatological conditions, particularly dry skin with associated itching and eczema; irritant and contact dermatitis; and skin breakdown associated with pressure

Basic skin-care needs of older people can be neglected or dealt with only when major skin breakdown occurs.

While there are many different types, rashes can basically be divided into two types: infectious or noninfectious.

Noninfectious rashes include eczema, contact dermatitis, psoriasis, seborrheic dermatitis, drug eruptions, hives and allergic dermatitis to name a few.

Infection-associated rashes, such as ringworm, impetigo, staphylococcus, scabies, herpes, chicken pox and shingles, are treated by treating the underlying cause.

Infectious agents that can cause a rash include viruses, bacteria, fungi and parasites.

A rash can be a helpful guide to the likely differential diagnosis.  Infectious disease and drug reactions give a short history whereas psoriasis and eczema may have been present for longer.

Any unusual skin lesions that appear and do not spontaneously resolve should be reported to a dermatology specialist. Cancerous skin conditions, require referral.

Other lesion changes that occur with age include cherry angiomas (small, red, benign tumours), moles, skin tags (fleshy, pedunculated warts in areas of friction) and liver spots. Bruising is related to the loss of subcutaneous tissue supporting the skin's capillaries.  These can be caused by minor trauma, especially on the extensor surface of the forearm. In some cases, this can be an indicator of elder abuse. These lesions can generally be left alone as long as they do not cause distress or present a danger to the individual.

In addition, one of the most common complaints among the elderly is Pruritus, which is a generalised itch and is usually caused by dry skin.  This is easily treated by avoiding soap products.  It is critical however, to distinguish cases of widespread itch with skin diseases (which are typically inflammatory) from those caused by trauma from chronic scratching.

To help ease dry skin an emollient will be needed, these include by are not limited to
Doublebase gel (Dermal)
Hydromol cream or ointment

Dermatologists (skin specialists) are best equipped to diagnose and treat most rashes, especially those that require biopsy or special tests.  Additionally, if you are unsure of the rash or unable to arrange an appointment, you can speak directly to your pharmacist who will be able to advise on what emollient to use or whether a Dr is required to diagnose.