Community care Resources

First, let’s celebrate the good news. Medical advances and healthier lifestyles mean that many of us will live to a ripe old age, easily outstripping the life expectancy of previous generations many of whom expected to retire at 60 and have ten or 15 good years in the sun before a sudden heart attack or stroke brought down the curtains.

However, as always with healthcare, there is always a cloud to darken any silver lining, and this one comes in the form of what is euphemistically termed ‘healthy life expectancy’. In simple terms this means that while it is definitely good news that many of us are living longer, the downside is that we are also more likely to develop any number of long-term conditions – heart disease, cancers, dementias, depression and respiratory conditions – which mean that our ‘golden years’ may not be as trouble free as we had hoped

According to the old saying, age is just a number, although exactly what that number is and how much time we have left is open to interpretation. Many of us might be satisfied to see three score and ten, while others hold onto their youth like the proverbial Peter Pan. Some among the so-called billionaire elite even imagine they can cheat old age through cryonics, freezing their bodies after death in the hope that technology might one day be advanced enough to revive them.

Whatever method we choose to keep age at bay, none of us are immune from the inexorable march of time and while UK government figures show that life expectancy is increasing (27% of the UK’s population is expected to be over 65 by 2072), longer lives come with their own issues (‘Preparing for an ageing society inquiry launched’ – committees.parliament.uk).

Heart failure and lymphoedema are common conditions that often coexist, particularly in older people. Compression therapy, a cornerstone of lymphoedema care, is frequently withheld in those with heart failure due to safety concerns. This article explores the interaction between heart failure and lymphoedema, summarises current evidence on compression safety, and provides practical advice for community practitioners. It highlights key assessment tools (NYHA class, NT-proBNP, vascular tests), addresses common misconceptions, and signposts to national guidelines. With careful assessment and collaboration between cardiology and lymphoedema teams, compression therapy can be used safely in most patients, improving outcomes and quality of life.

The number of people living with complex, multiple health conditions is increasing. It is estimated that almost three million people in the UK have three or more long-term conditions, whether these are physical or mental, psychological or cognitive (King’s Fund, 2020). In addition, people living in more socially deprived areas are at greater risk of developing such conditions. Nurses working in the community have a hugely important role to play in supporting people affected to live the healthiest lives possible — working with carers and families.

Venous leg ulcers make up a considerable part of the community nurse’s workload and the gold standard treatment is multilayered compression bandaging applied to cleansed and debrided lower limbs. The author of this piece looks at the background to leg ulcer development; as well as how to assess patients and the principles of prevention. This article also examines the KTwo^® bandaging system (Urgo Medical), which has a built-in pressure indicator to ensure that application is both consistent and effective. The make-up of the twolayer system makes it as effective as four-layer systems without the associated bulk, which means that patients find it easier to wear.

Rosemary Pudner discusses the management of patients with a cavity wound.