Frailty Service.

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What is this information about?

This information is about frailty and how the hospital Same Day Emergency Care (SDEC) Frailty Service can help you if you are living with frailty and have to come to the hospital for emergency care. It explains:

• what frailty is
• how frailty can increase the chance that you will have ill-health
• what the SDEC is and how it can help people living with frailty
• how you can expect to be treated by the Frailty SDEC team

Why have I been given this information?

You have been given this information because checks that you have had when you came into hospital show that you have frailty.

Reading this information will help you to understand what frailty is. It will also tell you how the Frailty team can help you to avoid some of the problems that being in hospital when you have frailty can bring.

What is frailty?

Frailty is a health condition that can happen to you as you get older. It is when several of the systems that make your body work properly lose their built-in reserves. They start to run out of energy and no longer work as well to keep you healthy.

Around one in ten people who are aged over 65 years have frailty. This rises to around half of people aged over 85 years old.

What are the signs that a person may have frailty?

Signs of frailty include:

• weight loss that you did not mean to happen (unexplained weight-loss)
• feeling very tired and that doing things is an effort (exhaustion)
• not getting much exercise (lack of physical activity)
• slowness. Not being able to walk at the same pace that you used to. 
• weakness. For example, not being able to grip things as well. 

What can happen to people who have frailty?

People with frailty may have a greater chance of:

• having falls
• being disabled (not being able to do things such as walk and move around)
• having to stay in hospital (being admitted to hospital)
• needing long-term care (having a carer at home or going into a care or nursing home)
• finding that minor events can cause big changes to their physical or mental health.

Is it better for me to stay in hospital if I have frailty?

For many older people living with frailty, it is better to be in their own home rather than staying in hospital.

What is the Frailty Same Day Emergency Care service (SDEC)?

The SDEC provides care on the day that you have come into hospital for emergency care. The care that we give you can mean that you do not have to stay in hospital (be admitted to hospital).  

We aim to improve the lives of people who:

• have come into hospital for emergency care and could need to be admitted and
• are over 75 years of age and
• are frail

Our focus is on supporting you and your family and carers to:

• recognise that you have frailty
• understand what frailty is and how living with frailty might change your life
• do things which might improve your condition or make living with frailty easier for you
• know about and get the support that you need.

How can the SDEC team help me?

The SDEC team will try to make sure that if you come into hospital with a condition that can be checked, diagnosed, and treated quickly without you having to stay on a ward:

• you get the right treatment at the right time and in the right place
• you can go home on the same day that we provide your care as long as that is medically safe for you.

The team will do a thorough check to see if changes could be made to help you when you leave hospital and go back to your home.

The check may include:

• a physical examination (For example checking your heart rate, blood pressure, strength, how much oxygen you have in your blood and your weight)
• blood tests or scans
• checking how well you can remember things (cognitive tests)
• a review of what medicines you are taking. We may change your medicines and when you leave hospital you may be given a supply of medicines. We will talk with you about any changes to your medicines. We will arrange for your medicines to be supplied if you need this.

Do follow your doctor’s instructions for taking your medicine.

You may also be seen by a therapist such as a physiotherapist or an occupational therapist who will see how you are and how they may be able to help you.

What might happen after I have had these checks?

After you have had these checks, we may:

• invite you back to one of our clinics
• refer you to a service that is run in the community. This is so you can get care at your GP surgery, a community hospital or in your home.

The frailty SDEC team have a daily meeting to talk about your care. This is like a ‘ward round’ on a hospital ward.

Will my wishes be followed when decisions are made about my care?

Yes. We will talk with you (along with your relatives or carers if you would like us to or we need to) about your wishes and what you prefer for your treatment and future care.

This may include asking you to fill out a ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) form. This tells us what you want to happen in emergency situations where you are not able to make decisions or express your wishes. Your ReSPECT form is shared with the teams looking after you in hospital and with any other healthcare teams who look after you once you have left hospital so that they know what your wishes are. Deciding and recording your wishes about how you are treated and cared for is called ‘advanced care planning’.

We will support you and your family or carers to:

• discuss any concerns you have about your health or things such as where and how you are living (your social situation)
• find further advice and support.

What kind of care can I expect to get?

• Our aim is to be compassionate and kind and to treat people with dignity and respect.
• We try to make sure our patients to have a positive experience and feel supported by the team. 
• We involve our patients, staff, and the public in making decisions about our services. This will help us to provide the best services that we are able to for people with frailty who are cared for by our Trust ((UHSussex).
• All information we collect about you will be stored securely. We may share it with other health professionals to support your needs.
• We expect the highest standards of behaviour and conduct from our staff.
• We always try to make sure that our service continues to get better and that we make the best use of our resources to benefit our patients.

If you have any concerns about the service, please speak with us or contact the Patient Advice and Liaison Service (PALS) phone: 01243 788122.

How can I help to improve the Frailty SDEC service?

Please let us know what you think of the service. We are listening and welcome your comments. They can help us to improve the service.

Who are the team looking after me?

The team is made up of:

• Consultant Geriatrician (an experienced, senior doctor who specialises in caring for older people).
• Registrar Geriatrician (a doctor who specialises in caring for older people. They are training to become a consultant).
• Advanced Clinical Practitioner (a health professional such as nurse who has had special advanced training and has experience in caring for older people).
• Other Allied Health Professionals. Allied Health Professionals includes staff such as physiotherapists and occupational therapists.

Who should I contact if I have questions or concerns about my health after I have gone home from hospital?

Please contact a GP or NHS 111.