From Bedbound to Mobile: The Role of the Newham Virtual Frailty Ward

1. Introduction

83 yo male who presented to hospital following 2 falls within a week. He had a background history of hiatus hernia. He was independent of all activities of daily living residing in sheltered, warden controlled accommodation.  Upon presentation to hospital he given antibiotics for chest infection and had a mild acute kidney injury. His electrocardiogram showed a 2:1 AV block and he was transferred to a tertiary centre for a pacemaker Upon return to hospital he had a period of significant deconditioning coupled with orthostatic hypotension which hampered his ongoing rehabilitation. He was discharged home with a doubled handed four times a day package of care, along with a hospital bed and single floor living. He was commenced on midodrine to aid with the postural hypotension he was experiencing. He was referred to the virtual frailty ward, a home based hospital ward, for ongoing clinical review and therapies

2. Method

Through a structured and individualised care plan via the MDT which included medication review and tailored exercise therapy plans helped regain muscle strength which he had lost in hospital

3. Results

RS gradually regained his strength and the postural hypotension significantly reduced. Eventually RS was able to sit at the edge of the bed and transfer into the riser recliner chair which had been ordered for him. He eventually began to walk short distances with a wheeled zimmer frame to progressing to mobility outdoors

4. Conclusion

Through a balanced MDT approach RS was able to go from being bed bound at discharge from hospital to walking with minimal assistance over a period of 5 weeks at home with the intervention of the virtual frailty team