Our Elderly Care team provide a crucial role for the Trust and our local community, we strive to achieve excellent patient care and experience each and every time.
Our Elderly Care team provide a crucial role for the Trust and our local community, by striving to achieve excellent patient care and experience each and every time for all our patients. The team provides care for approximately 250 inpatient beds spread across 2 sites and cares for the frailest and most vulnerable in society, as well as supporting other medical colleagues in caring for older patients. It also provides outpatient services and support to our community partners.
Patients present with a wide range of symptoms and signs. Every patient undergoes a comprehensive geriatric assessment depending on their clinical state. Some may present with weight loss or falls, others with breathlessness or chest pain. Our service is dedicated in supporting all older people over 80 and those with frailty needs.
Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves. Around 10 per cent of people aged over 65 years have frailty, rising to between 25 to 50% of those aged over 85. It is particularly associated with those who are falling and have subsequent mobility problems, those living with dementia or movement disorders, those living in 24 hour care and those suffering from delirium. It is well recognised that these patients benefit from holistic reviews by geriatricians who can take into account both medical, mental and physical needs of each and every patient.
For this reason, all our wards are staffed by multidisciplinary teams who work collaboratively to give the best chances for our patients to improve and recover. The wards are designed to be dementia and older people friendly, and our staff trained to be caring and compassionate.
I felt very ill when I came to hospital. I was treated with kindness and respect
The staff gave a full explanation of my mother’s condition and were very kind and caring.
All staff are angels – the ward is the place to be. Would rate 11/10 on trip advisor. Take it from me! All staff are legends - (feel safe & sound) hope I come here if I get ill. Thank you all.
The Elderly Care Department has two Acute Admission units dedicated for those who are older and those with frailty needs over the age of 65. These dedicated elderly care facilities are based on Ward 41 at Pinderfields (Pinderfields Acute Care of the Elderly or PACE Unit) and Ward 9 at Dewsbury and District Hospital (Dewsbury Acute Care of the Elderly or DACE Unit).
Each of these units aims to provide a comprehensive geriatric assessment of each patients’ needs taking into account their physical, mental and holistic needs. The intention of the assessment wards is to discharge those who are suitable for rapid/ early discharge within 72 hours of admission or move patients to the most appropriate ward or service for ongoing care. This ward has a daily consultant ward round including over the weekend and therefore, some individuals may remain longer on this unit if necessary.
The two units are slightly different:
Our acute services aim to provide rapid multidisciplinary assessment of those with frailty by ensuring patients are at the centre of everything we do. We achieve holistic comprehensive geriatric assessments in eligible patients by caring for them and their families. Members of the team enable true engagement and take time to ensure the best for the patients.
Increasingly, we also provide support to the Same Day Emergency Care Unit to ensure rapid turnaround care to enable patients to remain in their home environment as long as possible by providing extended and timely reviews to those who need specialist input or hospital based investigations and therapies rather than them needing an overnight hospital admission.
It is widely acknowledged within healthcare, that the care of older people who sustain a fracture of their hip or their femur (the long bone in the leg), do much better if they are cared for by elderly care specialists. For this reason, we have a dedicated Orthogeriatrics unit. This unit directly admits such patients, to ensure that they have rapid assessments by orthopaedic surgeons and that around the time of the operation they receive a review by a geriatrician, who then also takes over their care 72 hours after surgery. In this way patients receive the best care for their medical and surgical problem including ensuring that they receive the most follow up care for osteoporosis and measures are undertaken to reduce the risk of further falls.
Some older people and those with frailty need to stay in hospital longer and therefore their care is transferred to a base ward within elderly care. There is one general elderly ward at Pinderfields Hospital for this purpose and the other wards are based at Dewsbury and District Hospital. These wards facilitate the care for those with ongoing medical or nursing needs and also provide a place of safety for those who require psychiatric evaluation or require ongoing support from social services/ community services.
Step down wards increasingly are used for those who are medically optimised for discharge – this does not mean that an individual is fully recovered but is as stable as possible and safe to move from an acute hospital setting. It may mean they still need to be transferred to rehabilitation, an interim bed or they may be able to go home with or without extra support. The wards are supported by discharge coordinators who facilitate discharge to all avenues of ongoing care.
The elderly care team also provide reviews of patients on other wards under the care of other medical and surgical specialties at request. We support the complex needs team in supporting those with dementia and delirium and provide support to psychiatric services at both Fieldhead Hospital and at the Priestley Unit.
The elderly care department offer a range of outpatient services. Outpatient clinics are run virtually and in person at all three of the Trust’s hospitals. The department run general clinics but also more specialist clinics in osteoporosis/orthogeriatric services and for those who have movement disorders such as Parkinson’s.
The department also regularly liaises with GPs and community providers in providing e-consultations to answer queries or offer advice. The team also provides a dedicated line for medical and nursing professionals in the community in an aim to support hospital avoidance measures and also offer advice and support where necessary.
In the department it is well recognised that those with moderate and severe frailty needs often reside in 24 hour care. As we recognise that many patients with this degree of frailty may not survive even a minor illness, the department supports community providers and where necessary care homes to ensure such individuals have been offered an advanced care plan. The same can be organised for those at home, although the pandemic has reduced the feasibility of such visits. Home visits can also be organised for those who cannot come for an outpatient appointment although visits are streamlined by a virtual or telephone consultation.
As a department we do not stand still and we are always trying to improve our services, develop our research portfolio and participate in trials such as in post-operative delirium and community rehabilitation. We work closely with our community providers to support and provide educational opportunities both within the acute hospital setting and in the community where necessary.