Introduction People are living longer with more complex multimorbidity across the globe. Those living with multimorbidity are at higher risk of becoming frail. Frail people have significant palliative care needs but as with other non-malignant conditions, access to palliative care support for frail patients is challenging. This is in part to a lack of recognition of these patient cohorts being able to benefit from palliative care. The aim of this review is to identify the evidence on how palliative care needs are being identified and assessed in frail older people and any evidence on
Introduction Loss and bereavement are experienced disproportionately by older adults. Bereavement can be a traumatic and life changing event that has a significant impact on health and social support. (Croxall, 2016) Geriatricians will regularly care for grieving patients and relatives; thus, it is essential to understand this process and be able to signpost to support. (Meichsner, 2020) Although the geriatric curriculum includes end-of-life care, grief and bereavement are not included. (JRCPTB, 2024) This contrasts with the palliative care curriculum, which includes psychosocial care of
Over 70,000 hip fractures occur annually in the UK, most being osteoporosis associated fragility fractures that require surgical fixation. Established orthogeriatric intervention and standardised pre- and postoperative care improve outcomes. With 25% of patients sustaining another fracture within five years, post-operative bisphosphonate use is increasingly relevant. Periprosthetic hip fractures (PPFs), a growing form of fragility fracture, often lack orthogeriatric input and bone protection advice is not standardised, an issue seen at St Richard’s Hospital, Chichester. Aim- This study aims
Key words: acute frailty, triple assessment, comprehensive geriatric assessment, integrated discharge team (IDT) Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years. British Geriatrics Society emphasizes the importance of using these metrics early in the patient journey, particularly for those with high 4AT, CFS, or
Introduction: Older adults accessing hospital care represent a distinct population, in whom patterns of multiple long-term conditions (MLTC) may differ to the wider population, especially given a higher likelihood of complex health and care requirements. A recent scoping review identified variability in the definition and operationalisation of MLTC in older adults accessing hospital care, with minimal description of MLTC in UK hospitals and limited consideration of complexity. To address this research gap, we aimed to describe the epidemiology and complexity of MLTC in older adults accessing
Background Eastbourne, on the East Sussex coast, has a population older than the national average. Older people make up a significant proportion of the hospital inpatient cohort, so services should be adapted to their needs. Language plays an important role in inclusion, but evidence is limited about preferred language in caring for older people. Anecdotally, "Elderly Care" did not resonate with patients. To find out more, surveys were conducted. Methods Surveys were used to find out patients' views on the name "Elderly Care" and identify other names they might prefer. Inpatients over 65 were
Focus on Frailty – Implementing an Acute Frailty Pathway and Same Day Emergency Care Frailty Service
Introduction East Surrey Hospital (SASH) recognised in April 2024 that there was no acute frailty pathway or same day care service specifically for older people. It performed 3rd or 4th quartile for all performance indicators regarding the care of frail or older people. Older people occupied 60% of bed days at SASH and had the longest emergency department wait times. Materials and Methods SASH made a strategic commitment to improve outcomes for frail and older people. A best practice review and initial trajectory modelling led to trial of an acute frailty team. This resulted in a full business
Background "Dignity in death" (DiD) refers to avoiding suffering at the end-of-life by meeting individuals' physical, emotional, and spiritual needs compassionately and respectfully. This includes upholding autonomy, preserving individuality, and fostering open discussions about death while aligning care with the person’s values. Holistic care prioritises comfort and dignity, treating death with understanding rather than fear (Ignacio et al., 2016). However, little is known about how care home staff perceive "dignity in death," despite extensive research on hospital and hospice staff (Hemati
Introduction Delirium is a common acute neuropsychiatric disorder, affecting approximately 23% of older adults admitted to hospitals in the UK. It is often triggered by acute illness and is associated with a high in-hospital mortality rate of around 30%. While delirium typically resolves, many patients experience prolonged cognitive and functional decline. Despite its prevalence, structured post-hospital follow-up services remain limited, leading to increased emergency department (ED) reattendance, hospital readmissions, and delayed recognition of cognitive impairment. Method To address this
Introduction: National Osteoporosis Guideline Group (NOGG) guidelines published in 2022 significantly changed practice in orthogeriatric setting with recommendation for early treatment to address “imminent fracture risk” and recommendation for greater use of injectable therapies for those at “very high fracture risk”. Intravenous zolendronate is now considered first line treatment, particularly post hip fracture but additional services for provision of injectable therapies have not been created to address this. The aim of this work was to analyse treatment choices for patients entered on
Can the length of stay on Intermediate Care Units (ICUs) be reduced for non-weight bearing patients?
Introduction Fragility Fractures can lead to immediate complications, decline in health status, increase in hospital stay, increased care needs and reduction in the quality of life (Court-Brown C Clement N, Duckworth A, The Bone and Joint Journal, 2014 96-B(3) 366-372). However, the National Osteoporosis Society (2017) reported 80% of non-hip fractures were not offered strength or balance exercises It is estimated that fragility fractures cost the UK £4.4 billion which includes £1.1 billion for social care (Office for Health Improvement & Disparities, 2022). At Sussex Community NHS Foundation
Family carers of people with Lewy body dementia (LBD) often experience poor mental and physical health, reduced quality of life and high levels of strain/ stress. Psychoeducational or psychotherapeutic group interventions can enhance understanding and reduce social isolation but rarely address specific symptoms of LBD. The Lewy body dementia Admiral Nurse service (dementia specialist nurse model) offers support via telephone or online video calls. In 2022 the service developed on online psychosocial group programme for family carers aimed at supporting understanding of LBD, coping strategies