Ageing well: It’s in our own hands

Healthy Ageing Week, Saturday, March 20, to Saturday, March 27, 2021 An Irish Examiner and Cork University Hospital campaign to promote healthy ageing.

Dr Emer Ahern, Consultant, Geriatric Medicine, Cork University Hospital, explains the role we can all play in ageing well.


Getting older is something we do from the day we are born. It is predicted there will be 1.1 million people over the age of 65 living in Ireland in 15 years from now. This is a success story and a testament to our better health and social care.

We all want to age well. 20% of longevity is determined by our genes and the rest by how we live our lives

Studying global populations who age well, common factors include: having a purpose, belonging to and taking part in our communities, having good friends and family, everyday exercise (e.g. gardening, walking to the shop), eating well and ways to manage stressors, like reading, mindfulness, mass etc. 

It’s been a hard year for everyone, since Ireland's first case of COVID-19 in February 2020. Four weeks later, the Department of Health published guidance on ‘cocooning’ to ‘protect’ people over 70 years. Older adults became housebound overnight.



The GEMS team (or Geriatric Emergency Multidisciplinary Service team) at the Emergency Department at the Cork University Hospital. Picture Dan Linehan


Older adults are reporting more loneliness and stress, both associated with poorer physical and mental health and overall quality of life. Health and social care services for older adults have been hard hit; e.g. home support services, day services, respite, therapy, pharmacy, face-to-face appointments with GPs and Consultants.

Members of the catering department at Cork University Hospital, Katie Spillane, nurse, with Sharon Bickerstaffe (centre) and Noreen Corkery on Ward 2B, CUH. Picture: Denis Minihane

Older adults are reporting more loneliness and stress, both associated with poorer physical and mental health and overall quality of life. Health and social care services for older adults have been hard hit; e.g. home support services, day services, respite, therapy, pharmacy, face-to-face appointments with GPs and Consultants.

The CUH Department of Geriatric Medicine conducted a study on the impact of cocooning on people with dementia and their caregivers; it found deterioration in over half of the older adults with dementia. Over two-thirds of caregivers described increased difficulty in meeting the care needs of the person with dementia; carers described reduced life satisfaction, loss of sense of self and fear for the future. 

Culturally, we care very well for people who are dying in hospital. The grieving and healing process start with family and friends being at the bedside when the person dies. Healthcare staff have also lost this comforting ‘ritual’ of celebrating and honouring the life of the person we had tried over the past days and weeks to make better. This has now been erased by COVID-19 and it is the hardest and saddest part to reconcile with. 

More than 12,000 older adults attend CUH Emergency Department (ED) every year with new acute illness or injuries; e.g. stroke, falls, fractures, falls, weight loss or infection. 

Multidisciplinary Geriatric Medicine teams in CUH comprehensively assess older adults as early as possible, treating the acute illness or injury while reversing or modifying any identified cognitive and functional deficits and planning the community supports to promote recovery, health and wellbeing at home.

The Institute of Healthcare Improvement (IHI) Age Friendly Health System (AFHS) is a global initiative which aims to improve the quality of care delivered to older adults by aligning care with what matters most to patients and their family and friends.

The Geriatric Emergency Multidisciplinary Service (GEMS) is a team within the Department of Geriatric Medicine led by Dr Kirstyn James. In February 2021, it was the first healthcare system in Europe to achieve recognition as an Institute for Healthcare Improvement Age Friendly Health System (AFHS).

The Integrated Care Programme for Older Persons’ (ICPOP), CUH and Cork Kerry Community Healthcare are leading out on the development of an end to end pathway in Cork that describes connected services for older people in their communities. We are now ready to enter the sustain and spread phase of this programme of age-friendly care to as many older adults as possible in CUH and our communities.

While we rarely think of technology and ageing as going together, tech from wearable health monitors to telehealth to smart homes and social media help people of all ages stay connected.

The CUH charity funding will be used to adapt the specialist geriatric medicine in-patient unit and redesign the clinical environment to make it fit for purpose, age-attuned and promote age-friendly care. 


Getting Covid vaccine ready

Dr Evelyn Hannon 

Many people ask which is the best vaccine for me? The best vaccine is the first vaccine you are offered. All the vaccines used in Ireland are safe and effective in protecting us from serious covid illness. These vaccines are the first step to returning to a life filled with everything and everyone we love. 

What are the things you can do to maximise your body’s immune response to the vaccine?

Sleep matters

icon Try to get between 7 to 9 hours of sleep per night. 

icon Eat well and stay hydrated.

icon Good self-care. We know that stress reduces our ability to fight infection. Make sure you take time for yourself – read a book, listen to music or whatever you like to do to relax.

icon Exercise is key to boosting our immune response: 150 minutes per week of brisk walking can cause a 30% improvement in immunity levels. Even if you can’t do that, try to do more exercise than usual in the weeks leading up to your vaccine. 

icon Vitamin D is essential to our immune system.


Dr. Eoin Fogarty, consultant in emergency medicine, (left) and Joao Chourico, staff nurse, demonstrating the administering of a local anesthetic to the femoral nerve. Picture: Denis Minihane


Getting it right first time for people who break their hips

Every day in Ireland 10 older adults break their hip. The average age of a person who breaks their hip is 81 years and most (85%) are living at home.

Half of older adults who break their hip were walking without an aid or help before falling.

What is a hip fracture? 

Your hip is a ball and socket joint where the pelvis and thigh bone (femur) meet.

A hip fracture is a break in this joint. As we get older, our strength and balance may reduce and our bones become weaker due to diseases like osteoporosis, meaning that they break more easily.  If you have a hip fracture, the ED at CUH team will assess you and confirm the diagnosis after an X-ray. A local injection in the groin, called a ‘nerve block’, can greatly relieve the pain for several hours by numbing the leg and has fewer side effects than other painkillers.

In CUH, 95% of patients get a nerve block in ED.


What is the treatment for a hip fracture? 

Most people need an operation to fix the broken bone. The type of operation depends on which part of the hip has been broken. 
The main reasons for surgery are to relieve pain and to allow you to get up and put weight through your leg straight away, the day of or after surgery. Providing you’re well enough for surgery, the operation to repair your hip should take place within 48 hours of your arrival in the ED.

icon In Ireland, 76% of patients had surgery within 48 hours.

icon In CUH, 89% of patients had spinal anaesthesia reducing their risk of anaesthetic complications

icon 78% of patients in CUH are mobilised by a physiotherapist on the day of or after surgery


Better brain health: Stay active, stay connected 

Siobhan Cahill (Community Dementia Care Coordinator) 

An extensive body of evidence demonstrates that strong, supportive positive relationships and shared activities contribute to general wellbeing in older people. 

Conversely, loneliness and social isolation increase health risks amongst this demographic, with life events such as retirement, bereavement and ill health reducing social networks and making it harder to stay active socially. 

Research shows maintaining close ties to friends and family, along with meaningful social activities, may help people actively maintain their thinking skills in later life and arrest cognitive decline. A higher level of social engagement enhances brain health, with meaningful human interactions providing a buffer against harmful impacts such as stress.

The senior women social distancing while sitting on a bench at the park. Photo iStock


icon Join a club, class or social group, this has a duel benefit of an enjoyable activity and an opportunity to meet new people.

icon Maintain regular contact with friends, family members, grandchildren and neighbours who are important to you.

icon Stay connected through information technology such as social media, Facebook and online forums.

icon Volunteer to help others or share skills and talents via local schools or youth organisations.

icon Consider a pet - caring for a dog or cat can help give structure and purpose to the day and be a catalyst to social interaction.


Preventing another fall

Major risk factors for falling include decreased strength and balance and low levels of physical activity. 

There are many things that can be done to prevent falls: 
1. Balance and strengthening exercises 
2. Eating enough protein to keep muscles strong
3. Stopping medications that increase your risk of a fall 
4. Checking your heart & blood pressure
5. Checking your vision and glasses 
6. Making your home environment safer.

Can anything be done to strengthen my bones? 

Calcium and vitamin D are the basic building blocks of bone. Dairy products such as milk, yoghurt and cheese, fruit and vegetables including greens, kale, broccoli, potatoes, spinach and tomatoes, are good sources of calcium. Canned sardines and salmon are good sources of vitamin D, although our main natural source of vitamin D comes from sunlight.


Keep accurate, up-to-date list of “home” medications

Eimear Kennedy, Senior Pharmacist, CUH

Pharmacists are key members of the multidisciplinary team with a special focus on the safe use of medications. I visit the ward each day to review the medications that our older patients are taking. 

The first step when a patient is admitted to the ward is to ensure we have an accurate, up-to-date list of “home” medications. Our older patients often have long and complex lists of medications that they have been taking at home. An accurate list gives doctors a full picture, so that they can review, adjust or stop medication if necessary. 

If the patient is too unwell to talk to me about their medications, I will contact community pharmacists, GPs, caregivers or family to get the full picture.


Alison O'Connell and Samuel Baricaua, staff nurses, ward 2A. Picture Denis Minihane. 


Top tips for older patients taking medications

Keep an up-to-date list of your medications on your phone or in your wallet, including inhalers, injections, patches, eye drops, nasal sprays, vitamins and herbal products. Tell a family member where the list is kept. Your pharmacist can help you fill in the HSE’s ‘My Medicines’ leaflet, also available at www.safermeds.ie.

Always let your pharmacist or doctor know if you think you are experiencing a medication side effect. Never stop a medication without discussing it with your pharmacist or doctor. If you have trouble using your medication (e.g. swallowing big tablets or using an inhaler or eye drops), talk to your doctor or pharmacist about other possible options. 

Remember to KNOW, CHECK and ASK
KNOW your medicines list
CHECK how and when is best to take your medicines 
ASK your pharmacist or doctor if you are unsure


Telemedicine: video clinic visits  for older people

Dr Kirstyn James, consultant in geriatric medicine, CUH, on the value of video clinics



Dr Kirstyn James, consultant in geriatric medicine, CUH, on the value of video clinics


As a geriatric medicine fellow at Harvard Medical School, Boston, I received fantastic mentorship from Dr Andrea Wershof Schwartz, an expert in telemedicine (video clinic visits) for older people.
Little did I realise, that experience would become an essential skill during the COVID-19 pandemic.

What is telemedicine?

Telemedicine is a visit between a doctor or healthcare worker that takes place remotely using technology.

How does telemedicine work?

Your doctor may offer a telephone or video visit instead of a face-to-face visit. They will explain how it works and ask for details such as your telephone number or email address.

What are the advantages of telemedicine?

icon For patients living far away or with medical problems, it is more convenient.
icon It prevents transmission of COVID-19.
icon Family members or friends can join you at the visit, either in person or via video. 
icon Your doctor may not need to wear a face mask.

Will the doctor be able to fully assess me at a telemedicine visit?

Usually, my patients have to tell me how their home is laid out. On a video visit, they can show me around the room or whole house if they wish. I can see how the patient walks in their own environment or how they organise their medications.

I can complete many aspects of physical examination such as memory tests, observing walking and inspecting skin and feet. I can also pick up on low mood or shortness of breath. If a patient is familiar with checking their own weight or blood pressure, I will often ask them to do these measurements.

The main disadvantage is that I cannot complete my full examination. If I am worried about a patient and think they need to be seen face to face, I arrange that either as an emergency in our Geriatric Emergency Multidisciplinary Service at CUH or at our geriatric medicine clinic.

Tips for Accessing Telemedicine

icon If you would prefer not to do a video visit, ask if it can be done on the telephone or in person instead.
icon Check if you or a family member’s phone has a camera or computer/tablet device.
icon Wear your glasses or hearing aids during the visit.
icon Consider writing down any questions you may forget during the visit.
icon Sit in a comfortable place.Ask your doctor to repeat themselves if you didn’t hear the question or the connection was interrupted.
icon If you are not sure how to use the camera on your phone, ask a family member or you can call one of these free supports:

ALONE B Connect:
Tel 01 679 1032
Email- bconnect@alone.ie
Generation Tech:
Tel 01 963 3288
Email- ineedhelp@generationtech.ie

I have had the pleasure of meeting patients via video in their homes from Cape Cod to Carrigaline and hope to continue this service for those who want and need it even when COVID-19 restrictions are lifted. 


Support staff Helena Curran, (left) Neilus O'Callaghan and Dawn O'Carroll on ward 2B. Picture: Denis Minihane 

Irish Examiner 'Let's Talk Healthy Ageing' booklet in association with Cork University Hospital

Healthy Ageing Booklet

This report on Healthy Ageing was also produced as an information booklet by the Irish Examiner in association with Cork University Hospital, entitled 'Let's Talk Healthy Ageing'. It features contributions from CUH service teams spread across a range of departments, working to deliver healthcare services to people right across Munster.

CUH Charity is currently raising funds for full refurbishment of our geriatric care ward, creating a more homely feel, with private spaces to spend time with family and allowing CUH to deliver exceptional care.
Click here to learn more. 

The Irish Examiner and CUH information booklet 'Let's Talk Healthy Ageing', produced with the support of Home Instead Senior Care and MSL Engineering Ltd is a core element in the hospital's current public information campaign on geriatric services. 


Heartfelt thanks to the public for supporting children's services

Michael Nason, CEO, CUH Charity, thanks the public for supporting the CUH Children’s Unit.

Established in 2012, Cork University Hospital Charity is the charitable arm of the Cork University Hospital (CUH) and Cork University Maternity Hospital (CUMH).

We work closely with the management team and healthcare experts at CUH and CUMH to identify their most pressing needs and through the generosity of our individual and corporate donors, fundraising events and focused appeals, provide financial support for critical projects.

Since Covid-19 struck in March 2020 literally all planned fundraising activities were cancelled including the annual CUH Charity Gala Ball which takes place in October each year. And yet despite all the cancellations and restrictions human kindness shone through and people were extraordinary in their generosity.

People wanted to recognise and say thank you to the nurses, to the consultants and every member of staff for their tremendous and selfless commitment and outstanding work. So many companies contacted us to say any help we can give we will give, please just tell us how we can help.

People found ways to raise funds virtually and that has really helped us deliver on critical patient projects. On behalf of CUH Charity and everyone in the frontline we would like to say thank you for working with us through this time and thank you for the fundraising support that has come through. We are building a ‘Garden of Remembrance’ which we hope staff and patients will enjoy for many years to come.

We are raising funds to improve our Geriatric Ward and overall services. Given the number of older patients who use the services of CUH and the predicted demographic change over the next 10 years, it is vital that CUH becomes an age-friendly health system. 

We would like to continue to utilise technology to make it a more engaging place so when waiting on appointments for instance and when visiting we are reminded just how important it is to have an healthy lifestyle and so truly embrace the power of healthy ageing.   


For CUH Charity, dignity is non-negotiable

As people get older and frailer, the capacities that we take for granted can deteriorate.

Our mission is to deliver exceptional, kind and safe care and keep older people as independent as possible.

Any donations to this appeal will be an investment into the future of Geriatric Care in Munster.

With a target of €300,000, we intend to:
icon Undertake a full refurbishment of Ward 1A
icon Design the ward to create a calm, orientating, and supportive setting that feels more homely.
icon Creation of a dayroom, where patients can take their meals, interact with other patients, and experience private time with visitors.
icon Include a suite for patients receiving end-of-life care, to give our patients and their families a quiet, private space, away from the busy clinical area to spend precious time together.

You cannot put a price on dignity. We are asking for you to give whatever you can to support this campaign and support the older members of our community.


If you wish to learn more about the work done by CUH Charity and how you can help click here.


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