Loneliness among older people: a new epidemic

A weekly phone call or visit from a volunteer are among the solutions to help ease the loneliness epidemic affecting 1.2 million older people in England, according to campaigners.

Age UK, says that 1.2 million older people are chronically lonely and that this has an adverse impact on mental health, and the challenge will increase as our population ages. In the next 20 years, England’s over-85 population is set to rise from nearly
1.3 million people to just under 2.8 million.

Caroline Abrahams, Age UK charity director says: “Loneliness can have an impact on older people’s health and wellbeing. And this is particularly true when it comes to mental health, with older people’s depression often brought on by, or exacerbated by loneliness.”

NHS figures reveal that depression affects around
22% of men and 28% of women aged over 65 in England, but, according to the Royal College of Psychiatrists,
85% of older people with depression receive no NHS help at all. The spotlight on older people initiative – a group of nine older people’s organisations led by the Jo Cox Commission on Loneliness – says that more than half the users of over-50s social networking site Gransnet who say they are lonely have never discussed loneliness with anyone.

But solutions do exist, says Abrahams: “There is no quick fix or single policy solution to eradicate loneliness but there are reasons to hope that we can change things for the better.” An Age UK and Campaign to End Loneliness 2015 report, Promising Approaches to Reducing Loneliness and Isolation in Later Life, reveals good practice. For example, it says interventions involving help with transport or technology “can be the glue that keeps people active and engaged”.

The report highlights successes such as face-to-face or telephone befriending projects, including the Royal Voluntary Service’s Dorset Befriending Service, offering home visits to older people. The project began after a local GP’s concerns that older patients would visit the doctor primarily because they were isolated. Another initiative, The Silver Line, is a 24-hour, free helpline for information and companionship. In addition, British Red Cross community connectors are volunteers who identify and attend local activities with lonely older people.

The Campaign to End Loneliness is developing a national initiative to tackle loneliness through community collaboration. Laura Alcock-Ferguson, the campaign’s director, adds: “At a local level across the UK, health authorities should be developing clear plans to reduce loneliness and social isolation in their local areas.”

Dr Amanda Thompsell, chair of the old age psychiatry faculty at the Royal College of Psychiatrists, says organisations developing support projects must also include older people and carers as well as psychiatrists, GPs, and the social care sector. Thompsell suggests awareness of loneliness could also be incorporated into the school curriculum: “Inter-generational contact has been shown to be particularly effective in combating loneliness and we often forget how much children can learn from older people.”

Ignoring the challenge is not an option, as Thompsell says: “Failure to tackle loneliness will lead to more pressure on services which are already overwhelmed.”

Roy Warman: ‘I met the daughter I never had through a telephone befriending service. It changed my life’

Warman credits Age UK with helping to turn his life around Photograph: Amanda Searle

Roy Warman’s wife, Phyllis, died in January 2015. Buoyed by well-wishers in the first few weeks of bereavement, the visits and telephone calls gradually dwindled, and he felt increasingly alone. Many of his friends have passed away, he does not have any family nearby and the couple never had children. He explains: “The longer it goes without speaking to someone, the harder it gets.” He describes loneliness as “one of the hardest things that you will encounter in life”, likening feeling low to “living in a void”.

The 84-year-old from Wiltshire spotted information about Age UK in a local magazine a few months after Phyllis’s death. He got in touch and was referred to an Age UK telephone befriending service that matches older people with like-minded volunteers for friendship or phone calls.

He recalls the first time he spoke to a companion on the phone: “It opened a new door. It was so nice to think that someone might listen … a voice at the other end who could sympathise.” Today he has weekly phone calls with a volunteer he describes as “like the daughter I never had” and he also has regular visits from another volunteer as part of Age UK’s face-to-face befriending scheme.

The impact has been extraordinary, says Warman, describing the experience of support as “like being in a desert and coming across an oasis”. He has joined a singing group and developed his IT skills: “I think it partly affected my decision to join a local choir. And Age UK introduced me to the tablet, it’s like a giant library.” Crucially, he senses his self-confidence has returned: “I feel good about myself and feel able to cope now.” SS

Loneliness among older people: a new epidemic

Three-quarters of older people in the UK are lonely, survey finds

Almost three-quarters of older people in the UK are lonely and more than half of those have never spoken to anyone about how they feel, according to a survey carried out for the Jo Cox commision on loneliness.

The poll by Gransnet, the over-50s social networking site, also found that about seven in 10 (71%) respondents – average age 63 – said their close friends and family would be surprised or astonished to hear that they felt lonely.

Gransnet is one of nine organisations – including Age UK, the Alzheimer’s Society and the Silver Line helpline for older people – working to address the issue of loneliness in older people, which is the current focus of the commission, set up by Cox before her murder last June.

They are urging individuals and businesses to look for signs of loneliness and refer people to organisations that can help. But they also want people to take time to speak to neighbours, family, old friends or those they encounter randomly.

The chairs of the cross-party commission, the Labour MP Rachel Reeves and Conservative MP Seema Kennedy, said there was a stigma around loneliness that must be tackled.

“We all need to act and encourage older people to freely talk about their loneliness,” they said. “Everyone can play a part in ending loneliness among older people in their communities by simply starting a conversation with those around you.

“How we care and act for those around us could mean the difference between an older person just coping, to them loving and enjoying later life.”

Almost half (49%) of the 73% who described themselves as lonely in the online poll said they had been so for years, 11% said they had always felt lonely and 56% said they had never spoken about their loneliness to anyone.

Laura Alcock-Ferguson, the executive director of the Campaign to End Loneliness – another organisation working with the commission – said the percentage of lonely older people had stayed the same for five decades, but an ageing population meant the number was increasing in absolute terms.

“Loneliness is a serious public health issue and dealing with it will take the strain off the NHS and social care services,” she said.

Common trigger events said to have contributed to feelings of loneliness were bereavement, retirement and children leaving home. Being shy, living alone or far from family and low income were other commonly cited contributory factors.

The rise of social networking to the detriment of face-to-face interaction has been blamed for contributing to an “epidemic” of loneliness, but the survey of just over 1,000 people found it could also offer solace.

Almost three in five respondents (59%) said social media helped people feel less lonely and about eight in 10 (82%) said talking about loneliness was much easier when anonymous and online.

While the results indicate the potential benefits of online interaction, the older people are the less likely they are to have access to the internet, particularly women.

The commission is encouraging supporters and followers to post #happytochat on social media to create discussion around loneliness and for people to wear badges with the same slogan. Ultimately, they hope some customer-facing organisations will encourage their staff to wear the badges.

Respondents highlighted greater public awareness – a key goal of the commission – as the best way to combat loneliness.

Caroline Abrahams, charity director at Age UK, said: “There are reasons to believe that we can all do something to change things for the better: a simple thing like saying hello and having a chat can brighten up an older person’s day and do more good than most of us would ever guess.”

In coming months the commission will focus on loneliness in other groups, including men, people with disabilities, carers, refugees, children and parents.

Three-quarters of older people in the UK are lonely, survey finds

Parenthood can help you live longer in older age, research suggests

Parenthood could boost your chances of living longer in your later years, according researchers who believe the effect could be down to children helping with care and support.

While previous research has shown that adults with children live longer than those without, the new study unpicks how the effect plays out in older age.

“We started first at the age of 60 and we looked all the way up to the age of 100,” said Karin Modig, a co-author of the research from Sweden’s Karolinska Institute.

Modig and colleagues used national registry data to follow almost 1.5 million Swedes born between 1911 and 1925 as they aged. The team found that while the risk of death increased with age for all adults, having children was linked to greater longevity. The results are published in the Journal of Epidemiology and Community Health.

At the age of 60, men who had children had almost two years more on their remaining life expectancy than those without, at 20.2 and 18.4 years respectively. A similar trend was seen for women aged 60, with life expectancies of 23.1 years for those without children and 24.6 years for mothers.

By contrast at the age of 80, parents had a life expectancy of 7.7 years for men and 9.5 years for women, compared to 7 years for men without children and 8.9 years for women without children.

The team also looked at the risk of dying within a year for each age, taking into account factors such as education and marital status.

The findings reveal that the benefits of having children became more pronounced with age – an effect that was greater for men than women. Furthermore, the team found that having children had a stronger impact on the longevity of men who were not married than those with a spouse.

The researchers suggest that could be because unmarried men are more dependant on their children for support than men who are married, adding that previous research has suggested that men benefit more from marriage when it comes to survival than women do, possibly explaining why the effect is not seen for women.

Unlike some previous research, the authors found that the sex of the child had no influence on their parent’s longevity – however the finding was based only on families with one child. “Perhaps being the only child is related to a greater responsibility of parents, reducing the difference in the amount of help given by sons and daughters,” they write.

While it is not clear why having children is linked to a longer life, the researchers suggest it might be down to children helping to look after their ageing parents, be it through physical care, emotional support or even arguing for better treatment.

However there are other explanations, including that adults with children might have healthier lifestyles, or that there are other factors that could decrease an individual’s chances of having children and raise their risk of death.

But while having children might boost the years left on your clock, Modig says it is far from the only factor influencing longevity.

“In terms of all other causes that would affect your death risk in these old ages, having a child is not among the greatest ones,” she said. “But it is still a 1.5% difference [for 90-year-old men] which is still substantial.”

Parenthood can help you live longer in older age, research suggests

When my mum became a ‘bed blocker’, I saw the crisis in care for older people | Ros Coward

The case of Iris Sibley, trapped for six months in a Bristol hospital while her family and health authority hunted for a suitable care home, has highlighted how “bed blocking” is a key term in the crisis currently engulfing the NHS. When this week brought the news that nine out of 10 hospitals are overcrowded, NHS bosses pointed to major problems discharging patients. A&E’s failure to meet its four-hour target has similar causes and the excellent BBC TV series Hospital has highlighted how operations, both urgent and routine, are being delayed because beds needed for recovery are “blocked” by patients who no longer need to be in hospital.

Bed blocking is an impersonal term that expresses hospitals’ problems with resources. For the patients and family, it is much more personal. My mother became a “bed blocker” three years ago when, aged 89 and suffering from dementia, she collapsed and was admitted to hospital. She’d had several hospitalisations in the previous eight years but on the other occasions she’d been patched up and returned home. This time, after two weeks, she was declared stable but unable to cope any more on her own. I was told that a care home should be found, and rather sheepishly that the hospital “needed the bed back”.

We found a home within four weeks, yet it was another month before my mother was discharged

Like our society facing the coming crisis in elderly care, I wasn’t in any way prepared for this moment. Every time my mother had been hospitalised previously we’d seen first-hand what was being cited as the reason for much bed blocking: hospital weakened her, medication was altered, and her social care fell apart and became more difficult to re-establish as cuts hit social services. But in spite of all these mini-crises, we usually managed, eventually, to get her home. This time we had to make alternative arrangements.

The following five weeks were terrible. I was very distressed. I felt guilty. I had nightmares about making my mother leave her home. Contrary to Tory minister David Mowat’s recent comments that families aren’t prepared to care for their elderly parents at home, I clung to the hope that we could find a halfway house to rehabilitate her, or we could find additional social care to keep her at home. But the hospital kept pressuring and I shifted to scouring care homes and taking a crash course in what had become an overwhelmingly important issue: how a care home would be funded.

This was a lot of work, but ultimately it wasn’t me who held things up. We found a home within four weeks, yet it was another month before my mother was discharged. It is hard to pin down exactly why, but in the mix were cancelled meetings with consultants, staff absences and a lack of continuity between various agencies.

Worst of all was the finances. Endless time was spent researching funding and working on the care assessment form that determines the NHS’s contribution to care out of hospital. Despite huge numbers of older people now needing “medicalised” care of the sort previously provided in geriatric wards by the NHS, they are not entitled to full funding in care homes. But getting to the point of understanding entitlements and contributions and being therefore able to finalise the care home arrangements is a struggle. The eventual verdict had been anticipated by the discharge nurse five weeks previously: my mother was entitled to the basic further care element and the rest she would have to pay for herself, with the proceeds of selling her home.

Just as we began to gently prepare my mother for the move, she was abruptly shifted to another ward. She became extremely distressed and confused, and cried for the first time since entering hospital. And her whole care team disappeared – all the people with whom we’d been making these decisions and negotiating finances. The cause of this was again a shortage of beds, but for a person suffering from dementia and who was about to make the most important move of her life, it was awful.

It is not the fault of the NHS staff. In this instance they were uniformly compassionate. But while the staff don’t lack compassion, the system certainly does. Older people needing medicalised social care shouldn’t be pawns in a bureaucratic game where beds, forms and financial targets take precedence over humanity, while the NHS and councils, responsible for social care, desperately try to get the other to shoulder the costs. It’s shameful that resources are so scarce for the care of elderly people that it feels like horse trading to get anything at all.

Care for older people needs to change urgently. When my mother became a bed blocker the promises of the 2011 Dilnot report hung in the air. Dilnot was trying to rationalise the system, cap families’ contributions, and encourage social insurance to fund elderly care properly. Years later I’m shocked to find that nothing has changed. Theresa May talks about making Britain “work for all”, but Dilnot’s suggestions, which could improve life for elderly people and their families, have dropped off the radar.

When my mum became a ‘bed blocker’, I saw the crisis in care for older people | Ros Coward

Older patients seeing same GP each time "key to reducing hospital admissions"

Seeing the same GP each time they visit the doctor can reduce avoidable hospital admissions among older patients, a study published in the British Medical Journal has found.

But the government’s focus on increasing access to GPs, such as through longer hours, may have unintentionally affected the continuity of care patients experience, the authors warn.

The study, by researchers at the Health Foundation charity, found that older patients who saw the same GP most of the time were admitted to hospital 12% less for conditions that could be treated in doctors’ surgeries than those who had a lower continuity of care.

The researchers looked at ambulatory care sensitive conditions: these include long-term conditions such as asthma, where flare-ups can be reduced by high-quality GP care, acute conditions such as gangrene that can be prevented by timely treatment, and illnesses such as flu and pneumonia that can be prevented through vaccination.

Admissions for these types of illness are expensive for the NHS: hospital admissions for conditions that could be treated at doctors’ surgeries cost £1.42bn in 2009-10, or more than £170,000 for each GPs’ practice.

Under changes to the GPs’ contract introduced in 2014, all patients in England must have a named GP who is accountable for their treatment. But researchers at the University of Bristol warned in response to the BMJ study’s findings: “There is evidence that continuity of primary care is actually declining in the UK.”

In an editorial for the BMJ, they called for policies to help ensure greater continuity of care.

Seeing the same doctor more of the time could reduce hospital admissions because it “builds trust and a sense of mutual responsibility between patients and GPs”. Older patients were particularly likely to appreciate seeing the same GP, although they were less likely to receive it, the researchers said.

The editorial added: “A primary care system that is increasingly fragmented, in which neither patients nor doctors feel strongly connected to their local general practice, provides the setting for patients to choose to attend an emergency department.”

Difficulty in getting appointments at GP surgeries, “which are at least as overwhelmed as emergency departments”, compound the problem.

Improving the proportion of the time that patients saw the same GPs would improve doctors’ job satisfaction, and was “very likely” to reduce pressure on hospitals, they added.

The Health Foundation researchers analysed patient-level data for more than 230,000 people in England aged between 62 and 82, focusing on older patients because they make up a high proportion of GP appointments and avoidable hospital admissions.

Patients who experienced a medium level of continuity of care had almost 9% fewer avoidable admissions, while those who saw the same GP a high proportion of the time saw just over 12% fewer avoidable hospital admissions in comparison with patients who had a low continuity.

The researchers found a particularly pronounced association between continuity of primary care and reduced hospital admissions among patients who were frequent users of primary care, which they defined as more than 18 visits over the two-year period covered by the data.

The study was observational, and did not prove cause and effect, the researchers emphasised. But improving the continuity of care could reduce hospital costs, especially for the heaviest users of the system, they added.

A spokeswoman for the Department of Health said: “This government is committed to making sure patients can get the right care at the right time from well-resourced GPs and, from April 2015, all patients have had the right to continuity of care through a named GP, as part of the GP contract.

“This remains a key part of our plan to reduce pressure on hospitals, and is in no way diminished by extending access.”

Older patients seeing same GP each time "key to reducing hospital admissions"

Like many older women, I have an eating disorder. Time to remove the stigma | Gillian Harvey

As the cookie crumbles in my mouth, delivering a shot of much-needed sugar, a sudden urge flashes across my mind. I am tempted to grab another, and another, before dashing to the loo to purge. Stilling myself, I engage rationally with my feelings and manage to move on without giving in.

I’m not always so successful.

As a mother of five, and at 38 years of age, I’m under no illusions: I know I’m never going to be strutting down the catwalk; time has taken its toll on my once toned body and I’ve been through four stressful pregnancies. I want to be healthy, not excessively thin. But my anorexic and bulimic urges have always been more about control than any misguided notions of vanity.

That’s why I was unsurprised to read that recent research by UCL revealed that around 3% of women in their 40s and 50s have suffered from an eating problem in recent years. The number, which equates to tens of thousands, is probably just the tip of the iceberg – many sufferers, like myself, do not seek help when they experience problems. Instead, I have learned over the years, that I have to forgive myself when I slip up, pick myself up and focus on something else until the feeling passes.

My first foray into extreme dieting came at the age of 15 when, over the period of a few months, my weight plummeted from a healthy 55kg (8st 7lb), to just under 38kg (6st). What started as a vague wish to compete with my skinnier friend became an obsession that led to me skipping breakfast and lunch, and throwing most of my dinner into the bin.

I have come to believe that eating disorders, like a virus, lie dormant in our system, waiting to strike

Although I was initially motivated by the desire to be thin, looking back I can see that there was more to my illness than simple vanity. A combination of GCSEs, financial worries and feelings of inadequacy led me to focus on the one thing I felt I could control. And once on that path, the feeling of triumph I experienced every time the scales revealed weight loss was addictive in itself.

Despite the fact that I believed I’d beaten my anorexia back in the 1990s, it has resurfaced in various guises throughout my life: at university in my early 20s as an obsession with exercise; as bulimia in my mid-20s when I struggled with the stress of my first teaching post; even in my 30s, when adjusting to the demands of motherhood, I had to fight against the desire to make myself sick.

Since my original bout of anorexia, I’ve never weighed less than 44kg (7st). Something – my long-suffering husband, the thought of my children, or the realisation that I am hurting myself – always drags me back from the brink. The thought of passing on any tendencies to my children also plays on my mind, and I make sure I eat a healthy diet and encourage them to do the same.

But I’ve come to believe that eating disorders can never truly be cured; instead, like a virus, they lie dormant in our system, waiting for the right moment to strike. For me, the urge to diet excessively or – more commonly now – to binge and purge, comes when I’m moving house, am overworked or stressed. The disease is not a silly childhood blip that I can grow out of, but something that I will struggle to keep at bay throughout my life. Like an alcoholic, I am “on the wagon”, never free.

For women like me, the perception that anorexia is a disease of the young and is linked to narcissism is damaging. It’s embarrassing to admit, when teetering on the brink of your fourth decade, that you’ve just gorged on chocolate and found yourself hunched over the toilet bowl. But it shouldn’t be. Eating disorders are a mental illness; and while they may start with a wish to have the perfect body, the pattern of damaging behaviour that emerges is akin to a drug addiction.

The knowledge that disorders can flare up repeatedly throughout life, or even appear for the first time at middle age, should not lead us to despair, but give us greater understanding of what drives the anorexic brain and how sufferers can be helped. Eating disorders are often hidden, only noticed when a sufferer displays obvious physical signs; this is something acknowledged by the report’s lead author, Dr Nadia Micali, who noted that many of the women questioned told her that this was the first time they had ever spoken about their eating difficulties.

But bringing them out into the light, admitting that we have suffered or are suffering, is one of the keys to addressing the problem. Removing the stigma and challenging the assumptions that persist about eating disorders is the route to greater understanding and better health for those of us who struggle.

Like many older women, I have an eating disorder. Time to remove the stigma | Gillian Harvey

Half a million older people spend every day alone, poll shows

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Scale of loneliness among over-60s revealed as Age UK develops scheme to provide support and companionship

Half a million people over the age of 60 usually spend each day alone, with no interaction with others, and nearly half a million more commonly do not see or speak to anyone for five or six days a week, a poll suggests.

Age UK, which commissioned the research, said the results highlighted a growing number of chronically lonely older people, which was placing increasing demand on health services.

Related: Jo Cox’s campaign to tackle loneliness lives on with help of friends

Related: Loneliness is a hazard of old age. A phone call can mean a lot | Michele Hanson

Continue reading…

Half a million older people spend every day alone, poll shows

Four in five UK councils struggle to provide older people"s care – survey

Four in five UK local authorities have insufficient care for older people in their area, with the shortage most acute for some of the most vulnerable in society, research suggests.

The Family and Childcare Trust surveyed councils across the country and found they are struggling to meet needs amid a background of growing demand, budget cuts and recruitment difficulties.

The survey is published on the same day as an undercover investigation by BBC Panorama is to be broadcast, exposing shocking neglect at two Cornwall care homes, including vulnerable people being left unattended and a nurse saying she will use morphine to “shut up” a resident.

The deficit identified by the Family and Childcare Trust means more than 6.4 million people aged 65 and over are living in areas that do not have enough older people’s care to meet demand.

Only one in five councils reported having enough older people’s care in their area to meet demand, the survey found.

Just under half (48%) of the 182 councils (out of 211) that responded said they had sufficient availability of home care and a similar proportion (44%) reported having enough places in extra care homes, which allow people to live independently with 24-hour emergency or on-site support.

Only a third of local authorities said they have enough nursing homes with specialist support for dementia, which is predicted to affect one million people in the UK by 2025.

Claire Harding, head of research at the Family and Childcare Trust, which works closely with the government and local authorities, said: “It is inexcusable that vulnerable people are left unable to find the care that they need.

“We urge government to make sure there is enough care for everyone who needs it. In order to do this, we need robust data on where there are gaps in care, a funding system that truly meets the cost of providing care, and clear information for families.

“Without these steps, families will continue to struggle to find care and to meet the numerous care costs on their shoulders.”

The survey also highlighted large regional variations, with just 7% of outer London councils reporting enough older people’s care to meet demand. The only area where more than half of local authorities reported sufficient care was the north-east, where 57% responded positively.

The findings will add to the sense of crisis surrounding social care, with delayed transfers of care – when patients are medically fit to leave hospital but unable to be safely discharged – at record levels.

Council and NHS leaders, as well as the Care Quality Commission, have called for urgent action, with the chancellor, Philip Hammond, facing pressure to increase social funding in Wednesday’s autumn statement.

Inner London councils pay the highest rates for residential care for older people, at £649 a week per place, compared with the lowest rate of £464 in north-west England, according to the survey. The UK average for a residential place was revealed to be £27,113 a year.

A Department of Health spokeswoman said: “This government is committed to making sure older people throughout the country get affordable and dignified care. That is why we are significantly increasing the amount of money local authorities have access to for social care, by up to £3.5bn by 2020.”

Monday’s Panorama sees reporters go undercover at Clinton House in St Austell, and St Theresa’s, in Callington, near Plymouth, both owned by the Morleigh Group.

Hidden camera footage captured one resident left on a bed pan for 40 minutes and an out-of-date prescription supplement relabelled for use by another resident.

Clinton House is being closed as a result of safety concerns and St Theresa’s is under investigation by authorities along with two other Moreleigh Group homes.

Moreleigh Group said it had already removed the staff involved and reviewed its systems and procedures, prior to receiving information from Panorma. Cornwall council apologised for the failings.

Four in five UK councils struggle to provide older people"s care – survey

What are your experiences of care services for older and disabled people?

The safety of elderly and disabled people is being put at risk as care homes in England close, according to the Care Quality Commission (CQC) – with the watchdog concerned about what this means for the future of social care services.

In September 2010 there were 18,068 care homes in England, but in July this year the number fell to 16,614, according to figures released by the CQC. The closures are mainly due to the fact providers are struggling financially, with costs having increased by up to 30% in the past year while their profit margins have fallen by more than 40%. The CQC puts this – in part – down to cash-strapped councils unable to pay higher fees for these services.

It comes at a time of growing need linked to the ageing population. The regulator is worried that more and more home closures could leave needy, vulnerable older and disabled people with nowhere to go, putting more pressure on already struggling services.

What are your experiences of social care services in England? Do you have an older or disabled relative who is struggling, or have you had difficulties? Do you work in the NHS or social services? Are you worried about care home closures? Have you become a carer for a relative? Do you have concerns about state of the service?

Share your stories with us – anonymously or otherwise – and we will use a selection in our reporting.

What are your experiences of care services for older and disabled people?

Mind your language; they"re not "bed blockers" but older people

The NHS is faced with a rising tide of demand for care combined with a tight rein on both NHS and social care finances. The impact of these pressures is seen across the health and care system. It manifests itself obviously in delayed transfers out of hospitals.

Year on year these delays are rising, with more people staying in hospital when they don’t need to be there. It has an impact on the care of some of the frailest and most vulnerable people and is the subject of continued attention from the media, healthcare regulators and politicians.

When media and commentators discuss this issue it’s only a matter of time before a certain horrible term is used – “bed blocker”.

The phrase “blocked bed” originated in the UK in the late 50s, driven by hospital clinicians’ concerns about a lack of beds. Its use grew between 1961 and 1967, when the elderly population increased by 14% while bed numbers remained static. In 1986 “bed blocking” made its first appearance in a British Medical Journal headline. Although it was not accepted as a medical term, by the 90s it was being widely used by health economists as a marker of inefficiency.

The term persists to this day, despite many efforts to move away from it, such as the Department of Health’s redefinition of delayed discharge and delayed transfer in April 2001.

Surely the time has come to remember to whom bed blocking is referring. These “blockers” are often older people, who are frail and vulnerable and who would like nothing more than to return home to their families. The phrase “bed blocker” puts all the emphasis, and blame, on the individual. The reality is that it is the system that has failed to move quickly enough to put together the right package of care to enable the person in the bed to return home.

Language matters. How we talk about people reflects how we treat them and, in the health service, how we engage them in the care they receive. When we stop talking about people as people and instead use the language of the system (units, targets, blockers) we risk undermining the compassionate care the health service was created for and has delivered for almost 70 years.

I rarely hear anyone who works in the health and care sector use this phrase. Those working with and caring for people see the individual. They know their individual stories and what matters to them.

There is a quiet revolution under way in the NHS. It’s increasingly recognised that people should no longer be seen as passive recipients of their care but as participants in both the decision making process and the care they experience.

This is the right thing to do and what people want. But it is also a response to people’s changing health needs. With more and more people managing long-term conditions, sometimes more than one at a time, the old “patch ‘em up, ship ‘em out” approach is a thing of the past. The health service needs to work with people to manage their own care, and this means understanding their individual circumstances, wants and needs. To do this well also means looking beyond the health service towards their family life and other institutions like local government, schools and community groups.

The NHS Confederation brought together experts from across health and care to form a commission on improving urgent care for older people. In Sheffield, new processes discharge many more patients home, to be assessed there rather than in a mock environment in the ward. A saving of more than 30,000 bed days was recorded there over the first year and people report better experiences of care.

North east London foundation trust and the London Ambulance Service have together provided a home-based emergency assessment and care package for people who fall, resulting in only one in 20 recipients being admitted to hospital within 48 hours. There are similar examples in Derbyshire, Oldham, Greater Manchester, Norfolk, Aintree and right across the country.

The NHS has a way to go in making sure these examples make up a default approach. But the term “bed blocking” is unhelpful and arguably one of the most inappropriate terms in the healthcare lexicon. Let’s consign it to the dustbin and focus on what we know works both for the individual and the health and care system.

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Mind your language; they"re not "bed blockers" but older people

Research: Fish Oil Prevents Brain Shrinkage And Cognitive Decline In Older Adults

Three a lot more circumstances of Alzheimer’s disease will have been diagnosed by the time you finish studying this write-up. Much more than five million men and women have Alzheimer’s in the United States alone (44 million globally), and the price of new diagnosis is about a single new patient each and every minute, with no remedy on the horizon. Now a new study adds proof to the argument that fish oil supplementation could be one particular of the best preventives we have against the disease–at least for folks not at genetic chance for developing it.

Researchers from Rhode Island Hospital studied three groups of older grownups, ages 55-90, employing neuropsychological exams and brain magnetic resonance imaging (MRI) every 6 months. The group included 229 adults with no signs of the ailment 397 who had been diagnosed with mild cognitive impairment and 193 with Alzheimer’s. All participants have been element of the Alzheimer’s Illness Neuroimaging Initiative (ADNI), which began in 2003 and ended in 2010.

Alien fish oil (Photograph credit: zimpenfish)

Outcomes showed that adults taking fish oil, who had not nevertheless designed Alzheimer’s, experienced substantially less cognitive decline and brain shrinkage than grownups not taking fish oil. Cognitive decline was measured using the Alzheimer’s Disease Assessment Scale (ADAS-cog) and the Mini Psychological State Examination (MMSE). (However, the study did not specify the amount of fish oil taken, nor the percentage of EPA and DHA in the dietary supplements.)

These are promising final results, but they have a single significant caveat: advantages of taking fish oil only held accurate for individuals lacking the primary genetic threat aspect for developing Alzheimer’s, acknowledged as APOE ε4 . The researchers believe that individuals with APOE ε4  are incapable of metabolizing DHA, the fatty acid in fish oil thought to encourage cognitive benefits.

The researchers include, even so, that it is still possible that starting up fish oil supplementation in the course of or before middle age could safeguard against developing Alzheimer’s even for individuals with the genetic marker. If you feel of the gene for Alzheimer’s as a light switch, taking fish oil earlier in life could avert the switch from becoming flicked on.

At least that’s the hope, and given the truth that Alzheimer’s—the sixth top result in of death in the U.S.—still evades a remedy, fish oil will proceed to be a sizzling target of cognitive investigation as a achievable shield towards creating the disease.

The examine was published in the journal Alzheimer’s &amp Dementia.

You can discover David DiSalvo on Twitter @neuronarrative and at his website The Day-to-day Brain. His newest guide is Brain Changer: How Harnessing Your Brain’s Energy To Adapt Can Modify Your Daily life.

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Research: Fish Oil Prevents Brain Shrinkage And Cognitive Decline In Older Adults

Older Nurses To Obamacare"s Rescue, Increase Accountable Care

Registered nurses are delaying retirement, a perform determination that will aid make new accountable care models and the move away from charge-for-service medicine a lot more achievable beneath the Reasonably priced Care Act.

The choices by nurses to continue operating well into their late 60s and longer than they have in the past is assisting boost the nation’s provide of registered nurses (RNs), in accordance to a new study by the RAND Corporation, published on-line this afternoon in the journal Well being Affairs.

Virtually a quarter, or 24 percent of registered nurses, had been working as late as age 69. The trend has helped extend nursing careers by two.five many years soon after age 50 and “increased the 2012 RN workforce by 136,000 folks,” RAND researchers say.

These function alternatives will be vital given the worsening doctor shortage and reimbursement changes by government and personal insurers to inspire the use of more allied well being experts such as RNs, nurse practitioners, doctor assistants and pharmacists to meet the demand of a lot more newly insured Americans below the well being law.

Health insurance coverage companies, employers and government health plans are coaxing Americans a lot more towards a technique of population wellness via patient-centered health-related residences and accountable care organizations and away from classic charge-for-support medicine that encourages pointless tests and procedures. Below the new so-referred to as value-based mostly approaches of accountable care, primary care companies function more difficult, generally as a more coordinated crew, to keep sufferers out of the hospital, ensuring they are taking their medications and receiving care upfront in a doctor’s workplace, a wellness center or even a retail clinic.

ACOs and other new designs of health care delivery, which are pushed by the greatest of insurance coverage companies like Aetna Aetna (AET), Cigna Cigna (CI), Humana Humana (HUM), UnitedHealth Group UnitedHealth Group (UNH) and Blue Cross and Blue Shield strategies, see registered nurses being a crucial component of the staff that helps the physician coordinate care.

“ACA-induced changes in care delivery, mixed with the Medicaid and marketplace insurance expansions that have begun, suggest that there will be an enhance in the demand for RNs in care coordination, management, and ambulatory care positions,” Auerbach and co-authors Peter Buerhaus of Vanderbilt University and Douglas Staiger of Darmouth University wrote in their six-web page article published in the August situation of Wellness Affairs.

The boost in nursing comes from a number of diverse forces this kind of as a main focus on enhancing nurse schooling. That far more than doubled the variety of nurses to 181,000 in 2012 from about 74,000 in 2002, RAND explained.

However much more than 85 percent of nurses under 30 operate in hospitals, RAND researchers say they move to and are interested in doing work outdoors of the hospital as they age.  Hence, employers will uncover this shift a welcome growth.

“Older RNs are far far more probably to work outdoors of the hospital than younger RNs are – and thus the big number of older RNs searching for nonhospital employment could be a welcome improvement for nonhospital organizations that are looking for RNs,” the study’s authors wrote. “Hospital-based mostly RNs are often properly versed in competencies involving patient transitions and care coordination.”

Asking yourself how Obamacare will influence your wellness care? The Forbes eBook Inside Obamacare: The Repair For America’s Ailing Well being Care Technique answers that query and far more. Available now at Amazon and Apple.

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Older Nurses To Obamacare"s Rescue, Increase Accountable Care

We need to locate older faces gorgeous, says Esther Rantzen

“We should value older individuals far far more and recognise that we can learn from their useful expertise.

“Many older folks, who have been at the centre of their households, relied on in the workplace or local community – discover that with outdated age the tide goes out.

“They’re left stranded and turn into isolated.”

Ms Rantzen, 73, calls for far more new housing designed for older folks which would give them the needed assistance.

She said: “One of the clear techniques to help is to offer much more proper housing developments tailored for older individuals so they have the network to assistance their shifting demands.”

Last month Ms Rantzen accused Britain of getting to be “too busy” to uncover time for older people soon after The Silver Line received more than 100,000 calls in its 1st six months.

The former That is Lifestyle host stated the services was getting a “transformational” impact on 1000′s of men and women and had purchased to light as “huge and unmet need”.

Most callers lived alone and much more than half, 53 per cent, explained they had no one particular else to communicate to other than the helpline, a survey located.

Nearly half of callers frequently invested a lot more than a day without speaking to any person, and a lot more than one particular in 10 often invested a lot more than a week with no having a conversation.

Ms Rantzen launched the helpline right after revealing her very own feelings of loneliness when her husband, the documentary maker Desmond Wilcox, died.

“The shocking fact is that Britain has become as well hectic to find time for our older people,” she said. “Even our medical doctors, our carers, our higher streets and our households fail to recognise that what older folks need to have is time to speak, time to listen, time to worth them.

“Silver Line callers say that being encouraged to ring The Silver Line made all the big difference.”

We need to locate older faces gorgeous, says Esther Rantzen

Cancer charity claims older patients are currently being denied lifestyle-saving surgical treatment

The charity has mentioned sufferers are assessed for remedy bassed on age alone in some instances. Photograph: Naomi Harris

Older lung cancer individuals are becoming denied existence-conserving surgical procedure, a charity has mentioned. Those aged 75 or in excess of who are otherwise in excellent overall health and whose cancer has not spread are 5 times much less likely to be provided lifestyle-extending surgery than younger sufferers, Macmillan Cancer Assistance stated.

England and Wales have the worst five-year lung-cancer survival rates in Europe among the above 75s, a spokesman explained.

The United kingdom carries out significantly less lung cancer surgery on older individuals than in other European nations, he additional.

In some situations, sufferers are assessed for remedy based on age alone and not total fitness, the charity mentioned.

“I just cannot comprehend why healthful, older lung cancer patients are provided less daily life-saving surgical procedure than younger individuals, regardless of the fact that numerous could survive for many years afterwards,” explained Ciaran Devane, chief executive at Macmillan Cancer Assistance.

“It is deeply sad that our survival charges in this age group carry on to lag behind Europe. We should not send the message to older cancer individuals that it is Ok to discriminate.”

Cancer charity claims older patients are currently being denied lifestyle-saving surgical treatment

A day in the daily life of an older person"s psychological well being liaison nurse

‘Being capable to make a diverse to patients, even in the smallest way, is very fulfilling …’, says Ian Douglas. Photograph: Southern Health NHS basis believe in

Every functioning day is various for me, but I usually begin my mornings in the identical way. Up at six.30am, get ready and drop my children off at the train station, then I am in the Queen Alexandra hospital swimming pool by 7.40am and in the office at 8.30am.

I make efforts to be organised, but the truth is that each day is governed by the fax machine and my beeper. It’s a little unpredictable because I can be called at any time to a crisis predicament, for illustration if an older patient is physically and verbally aggressive and the ward workers need advice, or to a ideal interest meeting to support plan for the patient’s potential care demands. With a lot more and far more older people residing with mental health problems, there is a near constant demand.

Day-to-day tasks contain going by means of emails, checking the fax machine for new referrals and prioritising the work. Even with 3 nurses in the group we are in no way quick of sufferers to assess or re-evaluation on the ward. Twice a week we also overview our caseloads with a advisor psychiatrist. We examine the initial assessments, make a formal diagnosis, and organize professional comply with-up support.

The staff will use types produced by the Alzheimer’s Society to record fundamental individual details, such as their favourite foods, what they like to read through or observe on Tv, and who their closest pals and family members are. This means that the folks who give their care can make a far more private connection with them, which is crucial for individuals with situations such as dementia.

Though no day is structured, by some means the afternoons have a tendency to be more fraught. We face a amount of pressures, such as if a patient comes into the emergency division and requirements assessment but does not need a hospital bed. Element of our remit is to minimize the sum of admissions and of program pace up the discharge.

A massive element of my work is also delivering training. The workers in the hospital exactly where I am based mostly do a heroic task, but when our team was very first created 18 months ago, there was little experience of common mental overall health circumstances. There are ongoing pressures around a lack of information, but we are making enhancements that support give sufferers a much better service and employees the awareness instruction they need to have.

I’ve delivered dementia awareness sessions at Portsmouth University, and to some of the fire support and neighborhood police teams, which have been extremely productive. Other members of the group deliver coaching which is properly received as well. I’m also operating with nursing students at the University of Southampton to supply schooling by way of forum theatre, which assists engage them in the understanding procedure. Occasionally it’s the smallest gestures that can make a actual variation to patients, and giving communities that expertise is very potent.

I really like becoming out there talking face to face with men and women, which is precisely what works in the schooling sessions. It really is nicely documented that with a growing aging population, health specifications will boost, so the expertise of being capable to spot symptoms, diagnose and cope with mental wellness circumstances in older people are becoming more crucial.

The group works difficult to offer a completely integrated support for our patients, so it truly is not just about generating confident their wants are catered for even though they are in the hospital, but also when they leave. Much of the services the liaison team gives is about generating this occur. We talk to households and carers, GPs, neighborhood psychological health teams, social care teams, local community nurses, physiotherapists and voluntary organisations, and any person who is essential to ensure a full care strategy is in place for a patient when they depart hospital, so the assistance they need at property can start off the minute they arrive.

Prior to the liaison services, I was operating as a local community psychiatric nurse for four many years, so I have expertise of working with older individuals who have psychological overall health concerns. Becoming able to make a big difference to patients, even in the smallest way, is very fulfilling, and however it could be hectic and demanding, we’re proud to be portion of a extremely critical segment of the health services.

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A day in the daily life of an older person"s psychological well being liaison nurse

Never judge older ladies on their correct to have abortions | Viv Groskop

‘In 2012 there have been twelve,873 abortions performed to women aged beneath 18. This is the age group we must be safeguarding and listening to.’ Photograph: Alamy

The new details on abortions and the above-35s from the Department of Overall health is confusing – unless of course you presume, as numerous information reviews have so far, that ladies are stupid. Then it truly is easily explained.

We are supposed to think about that a six% improve given that 2001 in ladies in their late 30s and 40s searching for abortions is a “sharp rise”. This is supposedly since: (a) these girls mistakenly feel they are also previous to conceive and so will not require contraception and (b) the recession has manufactured “accidents” as well difficult to proceed with. The first part can make girls look idiotic. The second is incredibly intriguing – but fully unattainable to demonstrate.

The British Pregnancy Advisory Services reports that 4 in ten women aged more than 40 who went for an abortion more than three many years were not employing contraception. This is in contrast with fewer than one in 3 20- to 24-year-olds. I can see why you would look at these statistics and believe: “Ah yes, I see. Older females presume they cannot get pregnant. But they can! Younger girls are less very likely to believe like that.”

But what’s the real agenda right here? Josephine Quintavalle, of the campaign group Comment on Reproductive Ethics, gives us a clue: “Women have misplaced touch with the nature of human reproduction. Women require far more info about their very own biology. Not every little thing can be fixed with a trip to the chemist for the abortion pill or to the IVF clinic.” Here is the message, then: shame on those ignorant girls who thought they could “resolve everything” with their satisfied-go-lucky “trip”.

In this instance I am not positive that women do need a lot more details. I think they want to be respected, assumed to have a brain and a conscience, and left to live their lives as they choose. They are not selecting out specific outfits and matching luggage for their “journey”. They truly aren’t. (To be clear: I am personally not pro-abortion. I am pro-selection.)

It truly is disturbing that we are focusing on some thing as small as a 6% rise and attributing this to women’s supposed ignorance. In 2012 there had been seven,737 abortions carried out for females aged among 40 and 44 in 2002 this figure had been six,531. What does this increase prove? Perhaps women are getting more intercourse than they did in 2002. Perhaps they are pleased to get the risk of obtaining pregnant, and then realise it truly is a error for them. Maybe abortion is less stigmatised. Perhaps there are a number of socioeconomic and cultural factors that could all quite easily combine to make clear this very modest enhance. Crazy imagined, I know.

The actuality is that girls know that their fertility falls sharply after 35. But they also know that is not the exact same as being infertile. We only have to appear close to us to see the proof. I do not know any girls in excess of the age of 35 who, simply because they weren’t making use of contraception, have had an abortion. I do know of loads of “accident” infants who have stretched their parents’ finances to the restrict throughout the recession. And I know many ladies in excess of the age of 40 who have had infants.

In idealistic terms, of course no a single desires an abortion to consider spot. But individuals have to be allowed to make problems in their lives. The interpretation of this data is one more way to demean and to judge. It is also a hazardous distraction. In 2012 there have been 12,873 abortions carried out on girls aged underneath 18. This is the age group we must be protecting and listening to. These are the women we must be talking to about contraception and understanding your personal entire body. Older girls can search right after themselves. Never belittle their difficult-won selections – or their ability to make them.

Never judge older ladies on their correct to have abortions | Viv Groskop

I suffer from stage&nbspfright and it truly is&nbspgetting worse as&nbspI get older

‘I now even commence to feel nervous before rehearsals.’ Photograph: Getty Photos (posed by model)

I am rehearsing for a fringe manufacturing but considerably of the enjoyment is misplaced, owing to my continual stage fright. I have acted for much more than 30 years, but as I get older – I am now in my late 40s – this would seem to be getting considerably worse. I now even get butterflies in my stomach, and shaking legs and hands just before rehearsals. I love acting but I am concerned this dread will take in excess of and at some point stop me carrying out. Any assist would be gratefully acquired.

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I suffer from stage&nbspfright and it truly is&nbspgetting worse as&nbspI get older

At last, a medical doctor who respects older mothers | Lynsey Hanley

‘Women, although effectively conscious of the statistical risks of miscarriage and chromosomal problems, are not about to start off obtaining infants 10 years earlier.’ Photograph: Alamy

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists, is both a very good sociologist and a fantastic feminist. He has pointed out that ladies who delay getting their first kid till at least the age of 35 have a tendency to know what they’re carrying out. At final, contrary to statements produced by his personal college and other senior health-related practitioners, somebody has noticed that, in his words, “society has altered” and that girls, even though effectively mindful of the statistical dangers of miscarriage and chromosomal issues, aren’t about to start getting babies 10 many years earlier.

It was about time an individual in his place credited parents-to-be with a degree of awareness that other public figures have failed to do. Of course, delayed parenthood is “an irreversible trend” – the explanation I had my initial kid at 35, and am having my second at 38, is simply because I went to university in 1994, the 12 months in which increased schooling commenced to turn out to be an area of mass participation.

Just before 1994, going to university was a minority pursuit from then on, the quick growth of universities and former polytechnics enhanced entry for women and, to a lesser extent, those from doing work- and reduced middle-class backgrounds. I fell into both camps, and have come to see delayed motherhood as a consequence of social mobility.

For some, it’s a damaging decision, one thing they truly feel they have been pushed into, whether since of housing expenses, unreliable or uncommitted partners, function or just a general feeling that the time has not been right to get on with it. For other individuals, it truly is a good 1: you’ve had opportunities your dad and mom never had and you happen to be damned if you are not going to get them.

Educated girls are armed to the ears with details it is the last point they lack. Understanding the health-related dangers involved in leaving parenthood until later is weighed alongside having horizons widened, not purely in job and fiscal terms, but also in terms of travel, better general mobility, relationships and cultural pursuits.Drastically, Richmond did not handle the fact that the age at which you have your initial little one has a pronounced, and growing, class facet. The geographer Danny Dorling factors out that the last time the average age of motherhood was so substantial was when huge numbers of younger women have been in domestic services, a trend altered only by the 2nd world war. My grandmother, in services right up until 1939, then working in factories all through the war, had her only youngster when she was practically 34. My mum, neither born into services nor educated past 16, had me at 23.

Dorling’s investigation exhibits that women who haven’t been to university, living in regions where handful of men and women have higher qualifications, have children at quite much the age their own mothers did. Where after females in, for instance, parts of south Wales and Surrey would have started households at broadly the very same age, there is now a ten- or even 15-yr gap between distinct places so that now, he writes, “working-class grandmothers can be of a equivalent age to upper middle-class mothers”.

Moreover, says Dorling of the latter group, “the home incomes of these women’s families will rise faster than that of families in which females carry on to have children at the ages of their mothers”. This is the essential point: analysis published in the British Medical Journal shows that women residing in poorer places, in spite of having kids younger, have babies that are far more probably to die in their 1st yr of lifestyle, are much more likely to be born prematurely and much more likely to be born underweight. Inequality, and its results, is the genuine public health issue at perform.

Rather than lamenting the options of women who now have control in excess of a fundamental facet of their lives, Richmond has rightly acknowledged – and, in so carrying out, celebrated – the reality that they are not about to relinquish it on the basis of a degree of danger they feel we can take care of. Now that’s out of the way, maybe more energy can be devoted to receiving all girls to the exact same point.

Lynsey Hanley is a going to fellow in cultural studies at Liverpool John Moores University

At last, a medical doctor who respects older mothers | Lynsey Hanley

Older individuals in NHS care suffering in silence, says overall health services ombudsman

Dame Julie Mellor, the parliamentary and wellness services ombudsman. Photograph: Martin Argles for the Guardian

Older men and women may be “struggling in silence” underneath NHS care since they are reluctant to complain about the care they get, the parliamentary and wellness services ombudsman for England has said.

Dame Julie Mellor believes above-65s either concern a backlash if they raise troubles or will not like producing fuss, that means watchdogs are only seeing the tip of the iceberg of critical failings.

“Older folks are some of the most regular consumers of the NHS but they are much less very likely to complain about remedy and care when specifications slip to unacceptable levels,” Mellor explained in an report for the Day-to-day Mail on Monday.

“Our analysis displays that a quarter of older men and women never know the place to go to complain about the NHS, despite using the support much more frequently than folks underneath 65. Complaints are a gift to the NHS because that is how improvements are accomplished. Older individuals should be encouraged to complain and taken significantly when they do.”

Mellor said: “Nearly 80% of all the investigations we carry out are about NHS services. Even even though virtually half of NHS care and solutions are given to older people, only a third of the health complaints we investigate are about the care of older individuals.

“Of the situations we do see, there are frequent themes operating by means of complaints about the care of older people,” the ombudsman stated. “Misdiagnosis, personnel attitudes, poor communication with sufferers and households, substandard nutrition, and individuals not currently being treated with dignity, just to title a few.”

Calling for a “cultural shift in the way” complaints are dealt with across the well being and social care technique, Mellor said: “More needs to be carried out to tackle the toxic cocktail of reluctance by individuals, carers and families to complain, and a defensive response from the NHS when they do.”

In an interview with the Guardian final yr, Mellor accused hospital boards of “not understanding from their patients’ experience to avoid problems from taking place again”, warning that failure to listen sufficiently to individuals and discover from their complaints – as occurred in the scandal at the Mid Staffordshire NHS trust – was not exceptional.

Older individuals in NHS care suffering in silence, says overall health services ombudsman

Smoking "increases chance of breast cancer in older ladies by practically a fifth"

Smoking increases the danger of breast cancer in older girls by practically a fifth, a examine has located. The discovery adds to a developing fat of evidence linking exposure to tobacco smoke with the ailment.

US scientists who tracked the progress of all around 186,000 women aged 50 to 71 located that these who smoked were 19% more probably to produce breast cancer than those who had in no way smoked. Females who when smoked but then kicked the habit have been still 7% more at risk.

The final results held real even following accounting for alcohol consumption, which is a breast cancer danger issue that is much more frequent among smokers.

In 2009 the Global Agency for Study on Cancer concluded there was “limited proof” that smoking tobacco could set off breast cancer. But in the final few many years findings have led to a U-turn in expert view.

Last 12 months, researchers from the American Cancer Society reported outcomes displaying a 24% increased rate of breast cancer amid women who smoked.

The danger was much better amongst people who began smoking younger, both before they began menstruating or ahead of getting their initial kid.

The new study, published in the British Journal of Cancer, covered a time period of about 10 years. In the course of this time, 7,500 of the females have been diagnosed with breast cancer.

Dr Sarah Nyante, from the US National Cancer Institute in Bethesda, Maryland, said: “Our review adds to a developing entire body of proof that suggests an association in between cigarette smoking and increased breast cancer risk.

“Previous research have investigated this connection, but queries remained regarding the extent to which other breast cancer chance factors, such as alcohol consumption, may influence the results. A lot more work is now essential to recognize the mechanisms behind the website link among smoking and breast cancer in publish-menopausal girls.”

While other life style factors such as being overweight, consuming alcohol and lack of exercise are all acknowledged to improve breast cancer threat in publish-menopausal females, the part of smoking has been much more challenging to unravel.

Smoking is the biggest preventable trigger of cancer around the world. The habit is linked not only to lung cancer but cancers of the larynx, oesophagus, oral cavity, pharynx, bladder, pancreas, kidney, liver, stomach and bowel.

In the previous 50 years, it is estimated that six.5 million folks in the Uk have died from tobacco-relevant illnesses.

Dr Julie Sharp, head of health info at Cancer Investigation United kingdom, which owns the British Journal of Cancer, said: “Evidence remains inconsistent as to no matter whether smoking triggers breast cancer soon after as effectively as prior to the menopause, but this examine suggests it may possibly enhance a post-menopausal woman’s threat of breast cancer if she smokes or has smoked in the past.

“Quitting is not straightforward but, provided that smokers drop an common of ten many years of lifestyle in contrast to non-smokers, the advantages are enormous.”

Smoking "increases chance of breast cancer in older ladies by practically a fifth"