Characterising Multiple Long-Term Conditions in Older Adults Accessing Emergency Hospital Care
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
The name for healthcare of older people at Eastbourne District General Hospital: patients' views and our response
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
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
Exploring staff understandings of the phrase ‘dignity in death’ in the context of care homes for the elderly.
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
Geriatrician-led Outpatient Delirium Follow-Up Service
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
Promoting patient-centred inpatient care for Parkinson’s Disease by upskilling knowledge and confidence of ward staff
Better Updates, Better Care: Improving the communication with relatives in geriatric surgical patients
NOGG Guidelines and Application In Practice: Analysis of 3 years of NHFD data and bone health service provision at Royal Albert Edward Infirmary
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?
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
Feasibility and benefits of an online psychosocial group for family carers of people with Lewy body dementia
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
Better mealtimes for people living with dementia in care homes: A feasibility study
Nurses’ Views and Perspectives of Pain Assessment and Management in Residents with Advanced Dementia in Long-term Care Settings
The Impact of Lifestyle and Polypharmacy on the progression of Multimorbidity in Community-Dwelling Older Adults
Support and cognitive rehabilitation care at home in the management of early neurocognitive disorders
Rising Student Numbers – using a Comprehensive Geriatric Assessment exercise to educate surplus students?
Delirium prevalence in hospitalised inpatients across specialities: A review of a single hospital site.
Importance: Delirium affects up to 15% of hospitalised inpatients but prevalence rates vary by speciality. Outcomes for patients with delirium remain poor, but to improve care for patients having a full understanding of the burden of delirium within inpatients is an essential first step. Objective: To identify the prevalence of delirium on admission at a single hospital site across all specialities over a two-year period. Design: A retrospective analysis of all non-elective admissions 4A's Test (4AT) scores using Electronic Patient Records (EPR) data. Setting: A 600-bed urban teaching hospital
Effective use of Enhanced Observations in Forth Valley Royal Hospital
A new community based approach to the care of Acute Delirium
Background Current practice for acute delirium presentation is hospital admission whilst the delirium resolves, often including multiple transfers with poor outcomes. This project challenges this practice and allows people to recover at home with a maximum of 6 calls a day and night with carers trained in delirium. Results From a previous audit of Pathway 2 beds patients with delirium had poor outcomes, high levels of placement in permanent care and long lengths of stay (21 days). There have been 192 episodes of care through the Delirium Pathway.80% were from hospital wards and 20% stepped up
Utilising Digital Questionnaires to Identify Frailty in Older Patients on the Elective General Surgery Waiting Lists
Collaborative Care: Enhancing Frailty Management Through Nurse-Pharmacist Partnerships
Introduction: Frailty presents significant challenges to healthcare systems, particularly in Thurrock, Essex, where 14% of residents are aged 65 or older. This demographic shift, combined with socioeconomic factors, highlights the need for patient-centred, clinically effective, and tailored healthcare services that prioritise patient safety. Aim: To improve frailty management for elderly patients in Thurrock by integrating pharmacist support within a nurse-led service. The initiative focuses on improving medication management, alleviating workload pressures, and providing holistic care to