President’s Message

Hello Colleagues,

It’s hard to believe October is almost upon us! It seems at least at my workplace in Brisbane the relentless winter workload has eased, and I hope the trend is similar around Australia and New Zealand.  It does appear that COVID-related admissions have really dropped off, at least for the time being, and that gives me some hope that perhaps in the not-too-distant future COVID-19 will be no more of a concern than any of the other respiratory viruses we contend with each year. 

In the coming months I look forward to attending Division Retreats and meeting some of you in-person – the Queensland Division Spring Weekend in early October and then the New Zealand Division Retreat at the end of the month, as well as the NSW/ ACT Spring Weekend later in November. There is nothing better than meeting colleagues face-to-face to share stories and experiences, and discuss the issues that matter to you; these discussions often provide great insights into ways the Society can better support you, its members. If you can, I encourage you to attend.

The first meeting of the Dementia Care Special Interest Group was held on 25 August with an enthusiastic attendance of 43 people. Under the capable guidance of Chair Professor Sue Kurrle, the SIG is off to a promising start with working groups planned around models of care, education, advocacy and BPSD that will all strive to achieve practical outcomes to support the work of our profession. I look forward to seeing the efforts of this group unfold.

It has been two and half years since the release of the final report of the Royal Commission into Aged Care Quality and Safety. In July ANZSGM was asked to contribute to a review of implementation of recommendations – thank you to those who contributed to this important submission. This review provided an important moment to really look at what these recommendations mean for our work as geriatricians. Of particular relevance to geriatricians is Recommendation 58 -Access to specialists and other health practitioners through Multidisciplinary Outreach Services. As a Society we will continue to advocate for sustainable funding of multidisciplinary outreach models of care in residential aged care, of which there are already numerous examples in cities and country areas across Australia. The work of the Out of Hospital Care Special Interest Group will be a key component of that advocacy.

ANZSGM has also had the opportunity to weigh in on the foundation principles that will help underpin the new Aged Care Act in Australia – a piece of policy work that we hope helps to build a more equitable and higher quality aged care system. Thanks to all those that contributed, particularly new members of the Clinical Advocacy Committee. Tackling a submission request takes time and thought and we appreciate your contribution.

Rob O’Sullivan
President
ANZSGM

ANZSGM Welcomes New Members

The Society welcomes the following new members who were endorsed at the Council meeting on 14 August 2023:

NSW
Ram Ghimire (Full)
Suresh Sethuraman (AT)
Ruzanne Shah (AT)

New Zealand
Jennifer Cook (AT)
Bachan Giri (AT)
Shalini Rao (Full)
Wan Noormastura Wan Deraman (AT)

Queensland
Mathew Francis Arun (AT)
David Vernon (AT)
Erin Woon (AT)

Victoria
Waafiqa Alam (AT)
Ali Akram Ali Uthuman (Full)
Lauren Gilbert (AT)
Floyd Gomes (Associate)
Luke Ho (AT)
Qinyuan Hu (Full)
Rakhee Subramanian (AT)

Western Australia
Lisa Redgrave (Full)
Alexandra Wilson (AT)

Upcoming Division Events

ANZSGM Divisions will be hosting the following upcoming events:

ANZSGM New Zealand Retreat
26-28 October 2023
Napier Conference Centre, Hawke’s Bay
A diverse and exciting program is planned including, Advanced Trainee session, Challenges in General Medicine in the Older Person and Interactive Specialist Interest Round Robin. Guest speakers include: Prof. Adam Gordon, Professor of Care of Older People, University of Nottingham; President, British Geriatrics Society and Dr Sabine Sommer, Consultant Dermatologist, Te Whatu Ora Hawke’s Bay. Learn more about the program here.
Early registration deadline: 2 October 2023

NSW and ACT Division Spring Weekend
3-5 November 2023
East Hotel 69 Canberra Avenue, Kingston, ACT. (Use code DBANZS when booking.)
Save the date for this exciting three day event bringing together speakers and colleagues. Book your accommodation now using the code below and stay tuned for program details.

Kids dressing up as older people is harmless fun, right? No, it’s ageist, whatever Bluey says

By Dr Lisa Mitchell
Published in The Conversation on 22 September 2023

Have you ever had a patient decline to use a gait aid because they didn’t want to look ‘old’? Or someone stop doing something because of their ‘age’.  We might not be thinking about it, but age based stereotypes may be contributing to some of the health issues that we see in older people.  In this piece for The Conversation, I discuss how kids playing dress ups may be harmful to the health of current and future older people. Read here.

Image courtesy ABC

2023 ANZSGM Annual Scientific Meeting presentations now available

Content from the ANZSGM Annual Scientific Meeting held 10-12 May 2023 in Brisbane is now available to all members on the ANZSGM website. 

If you were unable to attend the ASM or would just like to revisit the presentations, the ANZSGM Video Library now includes recordings of 28  sessions from the three-day event along with their accompanying slides. 

We encourage you to explore this useful resource that reflects a scientific program from a host of esteemed speakers that acknowledges advances in geriatric medicine while recognising valuable lessons learned from projects.

Access the video library here.

Survey: Designing a Social Frailty Measure

Edith Cowan University invites clinicians and researchers in ageing, gerontology, or geriatrics; people aged 65 years and older; and caregivers of older people to participate in a research project to develop a Social Frailty Scale. 

Significance of the study
Social frailty can be defined as a lack of social resources and social activities, reduced social network and support, and compromised fulfilment of social needs. Social frailty is a threat to healthy ageing. It is important to recognise the risk factors associated with social frailty, to develop effective programs to prevent or slowdown social frailty.

Your participation in this research will involve completing an online survey in two rounds.
In each round, there will be statements about potential risks for social frailty. You will need to rank these statements based on how important you think they are, from “Extremely important” to “Not important at all”. After you finish Round 1, all answers will be combined, and you’ll get them back in a few weeks for Round 2. Each round will take about 7 minutes to complete. You will have two weeks to respond. Your participation is voluntary and confidential. If you would like to participate or want more information about the study read here.

For any queries, please contact Dr Manonita Ghosh m.ghosh@ecu.edu.au

Complete the survey here. 

This project has been approved by ECU-Human Research Ethics Committee (2023-04208-GHOSH). ECU Sage Lab development of the Social Frailty Scale is supported by the Medical Research Future Fund MRF2016045.

Sincerely,

Professor Loretta Baldassar, Dr Manonita Ghosh, Associate Professor Ivaylo Vassilev and Associate Professor Rosemary Saunders.

Edith Cowan University, 
University of Southampton.

Image Courtesy Edith Cowan University

ANZSGM Webinar ‘Anaesthesia for Geriatricians’  available on the ANZSGM website

ANZSGM Webinar ‘Anaesthesia for Geriatricians – a practical and irreverent look at the misunderstood and sometimes mysterious specialty of Anaesthesia’, presented on 20 September 2023, is now available for members on the ANZSGM website. 

The webinar is presented by the Perioperative Care of Older People Special Interest Group and moderated by Dr John Geddes, Dr Nadine Elias, Dr Christina Norris and Dr Divya Kumar and presented by Dr Dick Ongley, a public and private anaesthetist based in Christchurch, New Zealand/Aoteoroa.

All webinars from the ANZSGM Webinar series are available to members and can be  found on the ANZSGM website. 

Old People’s Home for Teenagers:  Why Geriatricians should be advocates for Intergenerational Contact

By Dr Stephanie Ward, Prince of Wales Hospital, Sydney

One of the great joys of geriatric medicine is the broad opportunities it can offer. As geriatricians, we may find ourselves marching down any one of many avenues, be it in acute medicine, outreach, peri-operative care, or sub-specialisation such as geriatric oncology. Many are further enriched by teaching, in administration, and in research. In our quest to improve outcomes for older people, as a community we continue to evolve our specialty by forging exciting new pathways upon which to walk. Yet, even by this reckoning of the expansive scope a geriatric medicine career can provide, a stint in televised factual entertainment must surely remain as one of the more unusual and unanticipated roads a geriatrician may step onto.  

And yet, that is exactly where Sue Kurrle and I found ourselves when we joined as expert geriatricians on ABC’s “Old People’s Home for 4 Year Olds”, a televised social experiment that examined the effects of an intergenerational classroom. In true geriatric medicine style, we worked as part of a multi-disciplinary expert panel, alongside a physio and psychologist, selecting and obtaining health measures to assess the impact of the programme, and we watched on with genuine curiosity to see how it would all unfold. Whilst cautiously optimistic, it’s fair to say the even our most hopeful of expectations were surpassed.

Old People’s Home for 4 Year Olds neither invented the concept intergenerational programmes, nor was it the first such program to take place in Australia. Yet the show, and its subsequent iterations including Old People’s Home for Teenagers, have amplified an important conversation around the possibilities such programs can offer. Intergenerational contact refers to the purposeful bringing together of two generations for the benefit of both, with bi-directional learning at its heart. The models and populations involved can be diverse, yet each has the potential to offer older people a sense of purpose and connection. By doing so, these programs may reduce loneliness, social isolation and related sequalae of depression, cognitive decline and even frailty. For younger people, the benefits of spending enriched time with an older person range from enhanced pro-social skill development in the very young, to increased confidence in the teenager years. At a societal level, intergenerational programs may be one of the most effective means to address ageism.

Interest in this area from a range of stakeholders, including educators, aged care providers and researchers, is growing. We argue that geriatricians, as clinicians who understand the diverse needs of older people, who champion holistic care, and who are seasoned in service development and evaluation, bring an important voice to this conversation. There is much work to be done to promote the judicious and sensitive design and implementation of intergenerational programmes Australia-wide, ranging from research, to co-design to workforce training and funding advocacy.

For geriatricians and trainees inspired by this exciting area, The Australian Institute of Intergenerational Practice is leading this charge, and we can recommend the website and membership (www.aiip.net.au). And for those new to the concept or want to be reminded about what intergenerational programmes can achieve, Old People’s Home for Teenagers Series 2 returns Tuesday 3 October 8.30pm on ABC Iview and ABC TV #OldPeoplesHomeAU.

Image courtesy ABC

In Memoriam: Dr Elizabeth Merson

Frailty Nexus

By Benignus Logan

The Frailty Nexus is an initiative of the Australian Frailty Network (AFN), led by Professor Ruth Hubbard. It was established as a peer support group for those with an interest in frailty research, including research students and early-career academics. It aims to build capacity in multidisciplinary and translational frailty research through networking, a monthly learning event, and a library of shared resources.

In alignment with AFN’s values of inclusion and collaboration, membership is open to anyone who wishes to join us. We already have many trainees and geriatricians as members.

The next Learning Link-Up (the monthly learning event from Frailty Nexus) will run on Wednesday 18^th October from 3-4pm (AEST; Brisbane time). The session is being presented by Dr Kristiana Ludlow, and is entitled: “Masterclass: Fundamentals of qualitative research”. It is for anyone curious about the world of qualitative research. and will cover:

•  Myth busting: addressing misconceptions about qualitative research
• Common qualitative data collection methods and analyses
• A guide to analysing qualitative data (using inductive content analysis, reflective thematic analysis, and codebook thematic analysis)
• Reflections on conducting qualitative research with people living with frailty 

Prior events have included “How to get that grant”, “Behind the evidence: Critical analysis of emerging Frailty literature (Anti-amyloid monoclonal antibodies for Alzheimer’s disease: Spotlight on donanemab)”, and “Implementation Science”.

Sign up as a member and receive access to past recordings, invitations to all future events, and request a diary invite for the next Learning Link-Up. 

Further information, and answers to any questions, can be found by emailing Benignus Logan at frailtynexus@uq.edu.au

Hip Fracture Clinical Care Standard

The Australian Commission on Safety and Quality in Health Care launched the updated national clinical care standard for hip fracture at the binational Hip Fest 2023 conference on 11 September hosted by the Australian & New Zealand Hip Fracture Registry (ANZHFR).

The updated Hip Fracture Clinical Care Standard (2023) for hospitals has reduced the maximum time to surgery from 48 hours to 36 hours in line with international guidelines. For the first time, this explicitly includes patients who need to be transferred to a hospital that can perform the surgery.
The Commission’s Acting Chief Medical Officer, emergency physician Associate Professor Carolyn
Hullick, said there was an urgent need for health services to offer better care for people with a hip
fracture, using the framework in the updated standard.

“Anyone who has seen someone live through a hip fracture knows it’s much more than a broken bone.
People with a hip fracture tend to be older, frail and more vulnerable, so it is critical the fracture is
repaired quickly to reduce pain and get them on the road to recovery back to independence,” she said.

“The data is sobering, as an Australian with a hip fracture is almost four times more likely to die within a year than someone of the same age who isn’t injured. This has an immense personal toll on individuals and families, in addition to the burden on our health system of around $600 million each year.” 

Much has improved since the Hip Fracture Clinical Care Standard was introduced in 2016, according to ANZHFR annual reports. The ANZHFR contains around 90,000 records, with 91% of hospitals
performing hip fracture surgery in Australia participating to help improve their hip fracture care.
While some hospitals have substantially reduced their time to surgery, there is still marked variation.

In 2022, the average time to surgery ranged from 16 to 92 hours, with the longest waiting times for
people being transferred for surgery. 78% of patients had surgery within 48 hours.

Geriatrician Professor Jacqueline Close, Co-chair of the ANZHFR and Co-chair of the expert advisory
group for the standard, knows first-hand the value of high-quality care for hip fractures and believes the updated standard will be a lever for change.

“The Hip Fracture Clinical Care Standard sets expectations for how every patient should be cared for,
while allowing for treatment to be tailored to the individual,” she said.

“The adage ‘don’t let the sun set twice before hip fracture repair’ has merit for several reasons. Firstly,
no-one wants to see their mum or dad fasting and in pain waiting for surgery; and shorter time to surgery is associated with fewer complications, better recovery and survival. “It is also more cost efficient to manage these patients well. Every day surgery is delayed, two days are added to the length of stay. The sooner you operate, the quicker patients can get walking and go home.”

Access the Hip Fracture Clinical Care Standard here.

AJA Volume 42, Issue 3, September 2023

As an international journal, we continue to reflect matters related to ageing across the world, in particular in our ‘neighbourhood’, the Australasia-Oceania region. In this September Issue, we revisit the topic of falls management, with two invited editorials. One focuses on the paucity of fall prevention research in Asian countries and emphasises the importance of considering the local context when conducting research – or applying evidence from elsewhere – within the Asia-Pacific region. The other highlights an innovative Kaupapa Māori program for fall prevention. These editorials were commissioned to mark the concurrent launch this month of a Virtual Issue on ‘Falls and fall-related injury: ascertainment, risk and prevention’. The Virtual Issue is a collation of articles the Journal has previously published on the topic. Thanks go to our colleague Dr Morag Taylor, who facilitated its production. The Issue also includes a brief report on a retrospective cohort study of falls and fractures in the acute care setting.

The Issue’s articles provide a comprehensive snapshot of research being conducted in the fields of gerontology and geriatric medicine. A comparison of two frailty measurement tools for use in a hospital environment is presented. Lawler and colleagues report on a study to determine barriers and enablers to participation in family-assisted therapy for older people in Transition Care.  Liang and colleagues discuss their evaluation of a multifaceted education and training intervention on advance care plan completion rates in a geriatric outpatient setting.

The complete Table of Contents and all articles can be accessed (subject to membership) at

Australasian Journal on Ageing: Vol 42, No 3 (wiley.com)

Job Alerts

General Medicine Physician
Full time
Hawke’s Bay, NZ
Application: Via website
Closing date: 11/10/23
Position description
Position Reference number: HAW07109
Contact: Rachel Leigh via Rachel.leigh@hbdhb.govt.nz
Listed: 19/09/2023

Consultant Geriatrician
Part time – Rooms for hire
South Coast Specialist Healthcare, Nowra
Application: Via email – admin@scsch.com.au
Closing date: open
Website
Position Reference number:
Contact: Vanessa Jefferies via 02 4445 3858
Listed: 15/09/2023

Consultant Geriatrician – Permanent
Full time
Nelson Hospital, New Zealand
Application: Via website
Closing date: 13/10/23
Position description
Position Reference number: N23-351
Contact: Felicity Hall via felicity.hall@nmdhb.govt.nz
Listed: 12/09/2023

Visit the ANZSGM job page here.