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Inside Health

Dying at Home, Familial Hypercholesterolaemia FH, Delirium

Inside Health

BBC

Health & Fitness, Science

4.4575 Ratings

🗓️ 18 October 2016

⏱️ 28 minutes

🧾️ Download transcript

Summary

Most of us say we'd like to die at home but few of us actually achieve this wish - something the NHS is keen to change. An award-winning GP surgery in Lancaster, The King Street and University Medical Practice, has transformed the way they care for patients reaching the end of their life, twice winning the Gold Standards Framework Quality Hallmark Award. Dr Nour Ghazal tells Dr Mark Porter what they've done to ensure their patients have a say in how and where they would like to die and Inside Health's Dr Margaret McCartney describes how important it is to broach that most difficult of subjects.

Familial Hypercholesterolaemia, also known as FH means that you have inherited high cholesterol levels and the consequences of this, if you don't know about it, can be deadly. Over half of men with FH will have a heart attack before they are 55, a third of women with FH before they're 60. But a simple genetic test can identify the condition and with a good diet, exercise and lipid lowering drugs like statins, people can live long and healthy lives. Steve Humphries, Professor of Cardiovascular Genetics at University College London tells Mark that only 15,000 people in the UK have a diagnosis of FH but it's thought that almost a quarter of a million people could in fact have the condition. So the race is on to identify and diagnose the thousands who don't know that they're carrying the suspect genes. Lorraine Priestley-Barnham, an FH clinical nurse specialist at Harefield Hospital in Middlesex describes the cascade testing being rolled out across the country in a programme supported by the British Heart Foundation. And three generations of the same family, father Chris, daughter Joanne and grandson, six year old Alfie, tell Inside Health how they found out they have FH.

Delirium - an acute confused state with hallucinations and psychosis - is incredibly common in hospitals. One in five patients can experience it, many more in intensive care. Fiona tells Mark about her own experience in ICU after major surgery last year, when she believed she was being held prisoner and experimented on. She tried to escape from the ward and her daughter, Catherine, describes how distressing it was to witness her mother in such a terrified state. Julie Darbyshire, Critical Care Research Manager at the University of Oxford has done some of the first research into patients' experience of delirium and ICU consultant pharmacist, Mark Borthwick, who has a special interest in the condition, tells Mark about the different types of delirium.

Transcript

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0:00.0

Hello, you're about to listen to a BBC podcast, and I'm Ed Gamble, host of another BBC podcast,

0:05.4

The Traitors Uncloaked. But my show is available only on BBC Sounds, just like Ellis and John's

0:10.6

Saturday bonus episodes, the Pop Top Ten podcast with Scott Mills and Ryland, and comedy specials

0:16.2

from the likes of Harriet Kemsley, Susie Ruffel and Rommas Shranger Nathan. However, and maybe I'm biased, it's really all about the traitors uncloked.

0:24.3

So for a whole bunch of exclusive scoops and podcasts, listen only on BBC Sounds.

0:29.6

Hello and thank you for downloading this programme, which was first broadcast on the 18th of

0:33.9

October 2016. Coming up today, familial hypercalestralemia, inherited high cholesterol levels that can lead

0:41.7

to a heart attack in your 30s. Only 15,000 people in the UK know they have the condition,

0:47.8

but there could be up to quarter a million more who don't. We join a team who are using

0:53.8

genetic testing to identify families

0:56.2

at risk before it's too late. Families like this. I'm Joanne. This is my son Alf. Hi. My name's Elfi

1:06.2

and I'm six. And this is my dad, Christopher. Hiya. And we're a family of FH, cholesterol.

1:14.2

Three generations.

1:16.1

More from Joanne and her family later, along with delirium.

1:19.6

Confusion, hallucinations and delusions are surprisingly common when people are ill.

1:24.0

But what does it feel like if you're the patient, particularly a polite one?

1:28.4

The nursing station wasn't far away, but I thought out of courtesy I must tell them I'm going.

1:34.0

And then I shouted out, I'm being kept here against my will.

1:38.1

So even though you thought you'd been kidnapped, you thought it courteous to let the staff know that you were leaving.

1:43.1

And then I remember trying to hit people with my hold-all.

1:47.0

I think I recognised my surgeon, but I didn't want to hit him in the place which hurt most.

1:52.4

And I remember thinking that, but I was still trying to hit somebody.

...

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