Frailty: Information for patients and carers

Frailty

During your admission you have been assessed by a frailty specialist nurse. We are based in the hospital and focus our care on older adults being admitted to hospital.

'Frailty' describes someone’s overall ability to recover from illness or injury. Frail people don’t bounce back as quickly from illness and accidents and this can impact on their long-term health and wellbeing. In practice, being frail means a relatively minor health problem, such as a urinary tract infection, can have a severe long term impact on someone’s health and wellbeing.

It’s important for us to assess our patients for frailty on admission so that we can provide the most appropriate care and support.

Our assessment

We discuss with you how you usually manage at home, when you are well.

We ask about your home environment and everyday activities including your existing home support/care, personal care needs, toileting, mobility, nutrition, medications, vision and hearing.

We will talk to you about falls and will ask how many times you have fallen in the past year.

We complete a simple cognitive assessment. While this is designed to identify delirium, it is also useful as an indicator of memory problems. If there are any concerns, we will monitor you and ask your GP to follow up once you are home.

If you have a dementia diagnosis we will ask you and your family/carers about how you manage this and what we can do to help you while you are in hospital.

What do we do with the information?

We complete a document called a comprehensive geriatric assessment (CGA) using the information you have provided.

“Comprehensive Geriatric Assessment (CGA) can lead to improved function and quality of life, and reduce hospital stay, re-admission rates and institutionalisation”

Taken from:

Conroy, S (2012) Silver Book: Quality Care for older people with urgent and emergency care needs (opens in a new tab).

We make recommendations for ward staff to follow so they can best support you during your admission.

We make referrals to other teams in the hospital such as physiotherapy, occupational therapy and dietitians.

We make referrals to some community teams and voluntary services.

If we think it would be beneficial for you to be under the care of a geriatrician (specialist older person’s doctor), we may recommend that you are moved to an elderly care bed.

Depending on your needs, we might review you again during your stay.

What you and/or your carers can do

• Try to keep moving.
• Get up and stretch your legs.
• Sit in the chair for a while every day, for example, while having your meals.
• If you are usually able to walk to the toilet at home, try to do the same here in hospital. The nurses will help you if you need them to.
• You might not have much appetite, but try to keep eating, little and often. Your family can bring in extra food and drinks from home that you might prefer.
• Try to keep hydrated. It is important to drink enough fluid.
• If you are struggling to eat, ask ward staff about supplements. These are drinks with additional calories in that are stocked on most wards.
• Try to wear your hearing aids if you usually do. This helps you and us.
• It’s important to have regular bowel movements. Please tell nursing or medical staff if you are constipated as they can give you medication/treatment to help.

To help you once you are home

Before you leave, the ward team will assess your ability to manage at home. They will discuss any concerns you may have and can ask the therapy teams to review your needs.

You may be discharged with a care package and there are other services available in the community who can offer you additional help.

Here are a few:

Age UK:

Information, advice and a service that delivers practical support at home. This includes befriending, warden service, day services and friendship clubs.

0800 678 1602 or visit the ‘Age UK’ website

Care Network:

Hospital discharge support, as well as practical and emotional help to increase confidence and independence.

Cambs, South and East Cambs- 01223 714433

Huntingdonshire and Fenland- 01354 694413

Community navigators:

Offer support, information and guidance to help adults to effectively access local support and activities.

Cambridge- 01223 300460

East Cambs- 01353 659639

Fenland- 01354 695208

Huntingdonshire- 01480 775493

South Cambs- 01954 212100

Dementia UK:

Admiral Nurses provide free support and advice to anyone affected by dementia.

Dementia Helpline- 0800 888 6678

E-mail Dementia UK

Alzheimer’s society:

Dementia Support Line 0333 150 3456

Cambridgeshire Dementia support Team 01223 620962

Email Cambridgeshire Alzheimers

Caring Together (Cambridgeshire only)

Information, advice, support and services for carers and the people you care for.

Tel: 0345 241 0954

E-mail Caring Together

Arthur Rank Hospice Palliative Care Hub

24 hour phone service for adults with life limiting illnesses in Cambridge and Peterborough, supported by the Arthur Rank Hospice Charity.

Dial 111 and select the “Palliative and End of Life care” option.

Social prescribers

Signpost to community services, help with forms, welfare benefits, blue badges, provide links with dementia support workers/dementia singing groups, befriending schemes, cafés

Contact through GP practices

Adult social care

Complete needs and financial assessments to help source support.

Contact through local county council.