Frailty Unit - Information for Patients, Families & Carers

You have been admitted to Borders General Hospital because of a sudden illness and/or injury.

At triage you were identified as living with frailty, and you have therefore been directed to the Frailty Unit Multidisciplinary Team.

As part of a Comprehensive Geriatric Assessment, you may be seen by Doctors, Nurses, Physiotherapists, Occupational Therapists, Dietitians, Pharmacists and Speech and Language Therapists.

Frailty is when your body has less reserve to bounce back after an illness, injury or other stress. People living with frailty are more likely to experience:

• Falls
• Reduced mobility
• Sudden confusion (delirium)
• Bladder or bowel changes (incontinence)
• Side effects from medications

Hospital is not always the best place for people living with frailty. Prolonged stays can increase risks such as falls, infections and deconditioning (losing strength). Our team will support you to return to a homely setting as soon and as safely as possible.

“Active Wards”

We aim to keep you as active and independent as possible during your stay. Getting up, dressed and moving—when it is safe—helps prevent deconditioning and can reduce delays in going home. From admission, we work with you to agree a planned date of discharge.

What to bring (if available):

• Day clothes (comfortable and easy to put on)
• Supportive shoes or slippers
• Walking aids
• Glasses, hearing aids and batteries
• Dentures and denture box
• A small supply of toiletries
• Something to do (for example, a book or magazine)
• A small personal item for reassurance
• Your current medicines in their original boxes, plus your repeat prescription list

Helpful information from family and carers:

It helps us to understand what matters to you, your daily routines, your usual abilities, and any changes noticed at home. Families and carers are welcome to share this information with ward staff.

Medical Team
Your care is led by a named Senior Doctor who oversees your treatment and plan. You may also be seen by  other Doctors on the ward during your stay.

Nursing team
Registered Nurses and Healthcare Support Workers provide day-to-day care, monitoring and support. On arrival you will be given a named Nurse who oversees your journey. If your stay is longer, this person may change, but we aim to keep continuity wherever possible.

Physiotherapy
Physiotherapists and support workers help restore movement, strength, balance and confidence after illness or injury. They will assess you, agree goals with you, provide exercises, and support discharge planning.

Occupational Therapy
Occupational Therapists and support workers help you regain independence in everyday activities such as washing, dressing, cooking and getting about safely. They may recommend equipment, advise on your home set-up, and—if needed—refer you to community services for ongoing support.

Clinical Pharmacy Service
The Pharmacy team support patients to gain maximum benefit from their medicines. They work with the  clinical team to ensure treatments are safe and effective and aim to reduce medicine related harm via ongoing medication assessment.

Dietetic Service
Dietitians and support workers assess your nutritional needs, especially if you have lost weight or are  struggling to eat and drink. They will give practical advice to support recovery and can refer to community dietetics on discharge if needed.

Speech and Language Therapy
Speech and Language Therapists assess and support communication and swallowing difficulties, which can happen after illness. They also guide families and carers on communication strategies and managing  progressive conditions.

Integrated Discharge Team
The team provide a person-centred approach to help patients maintain independence. Their assessments allow them understand the support needed for returning home, and arrange referrals to the most appropriate community services to ensure continuity of care where required.

We plan for going home from the day you arrive. You and your family can help by arranging:

• Keys: Have house keys available on the day of discharge
• Key safe: Share the key safe number (if you have one)
• Transport: Can a family member or friend collect you? Are there any access issues at home (for example, stairs)?
• Food: Arrange basic food supplies at home, or consider an online grocery delivery
• Heating and utilities: Ensure heating and hot water are on
• Clothes and footwear: Comfortable, safe footwear for leaving hospital
• Walking aids: Make sure these are available for your journey and at home

Our goal is to deliver care at home or as close to home as possible.

You may:

• Return home without further input
• Return home with support, for example from community health teams, Home First Services, or care at care home services
• Transfer to a local Community Hospital for short-term therapy before returning home

Your discharge pathway depends on your assessed needs and what is safest for you.

Everyone’s recovery is different. The time it takes depends on your illness, frailty, other long-term conditions, age and your usual level of activity. It is normal to have good days and tougher days.

Eating and Drinking

Eating well is essential for recovery. Many people lose weight after a hospital stay, and appetite may be low at first. Think of food as part of your treatment.

Hints and Tips:
• Start with small portions and eat more often
• Aim for three small meals and three snacks a day—include a dessert
• Fortified milk: one pint of whole milk mixed with four tablespoons of skimmed milk powder; use it in
   drinks, cereals and puddings
• Fortify meals with high-energy foods (for example, whole milk, double cream, cheese, oil, jam, sugar)
• Company helps: eating with others can boost appetite
• Avoid low-fat, sugar-free or diet products while you are rebuilding strength
• Keep sealed snacks close to hand if you are less mobile (for example, biscuits, cake bars, flapjacks)
• Ready-made, tinned or instant foods can be useful stepping stones 
• Consider meal delivery services (for example, Wiltshire Farm Foods, The Food Train)
• Drink most of your fluids after meals, as drinks before eating can make you feel full
• Keep your mouth and teeth clean
• If you have constipation or diarrhoea, speak to your doctor or pharmacist

If you continue to struggle at home and are not already known to dietetics, ask your doctor about a referral to the community dietetic service.

Sleeping

Sleep problems are common after a hospital stay. Sleep helps your body and emotions to heal.
• Short daytime naps can help you avoid becoming overtired
• Try to keep a regular routine (bedtime and wake time)
• Some people experience vivid dreams or hallucinations after serious illness; these often fade over time. Speak to your doctor if they persist or distress you

Keeping Moving

Illness and time in bed can lead to muscle weakness, stiffness and pain. You will be encouraged to get moving
as soon as it is safe, and you should continue to gradually increase activity at home. Aim to do a little more each day, with rest and food between activities

If you were given exercises, try to reach a level where:
• Your muscles feel slightly tired
• You are breathing a little harder but can still talk
• Your heart rate is a little faster

Recommended Guidelines:

• At least 150 minutes of moderate-intensity activity each week
• Strength activities on two days each week
• Balance activities on two days each week
• Break up sitting time as much as possible

Tip: Keep a simple activity diary to track progress and keep you motivated.

Daily Living and Keeping Independent

Practice everyday tasks that matter to you—washing, dressing, preparing a simple meal, making a hot drink,
walking to the toilet, and managing steps safely. Occupational Therapists can advise on equipment and ways to do tasks more easily and safely.

Medications

Your medicines may have changed during your stay.
When you go home:
• You will receive an updated list of your medicines
• If your medicines are different from before, your Practice Pharmacist or Doctor can review them with         you
• Ask if any medicines were stopped and why, and how to take any new medicines safely
• Keep medicines in their original boxes and use a daily checklist or pill organiser if helpful

Memory, Concentration and Confusion

After illness, your brain can tire more quickly. You may feel muddled, anxious, low in mood, or find it harder  to remember or concentrate—especially in busy or noisy places. This often improves gradually over weeks to
months. Speak to your Doctor if you are worried.

Hints and tips:

• Start with short reads or short television programmes
• Try quiz shows, simple crosswords or puzzles
• Family and friends can help by having unhurried conversations in a quiet space
• Allow extra time for tasks; doing them yourself helps the brain to re-learn

Staying Connected and Going Out

• Busy, noisy places can be hard at first—build up gradually
• Plan short trips to begin with
• It is fine to leave early from events as you rebuild stamina
• Consider local day centres or social groups when you feel ready

Being in hospital effects patients, families and friends in different ways. Some people like a timeline or diary to fill gaps in memory; others find that distressing—choose what feels right. Feelings of guilt are common. It is natural for patients and families to experience a range of emotions during and after a hospital stay.

Families may find it helpful to speak to someone independent (for example, a listening service or your local GP).

We will help you to access support identified during your stay. Some needs only become clear after you get home—please do not struggle on. Speak to your Doctor or the services below.

If you need help at home (for example, washing, dressing or meals), Scottish Borders Council – What Matters Hubs can advise on benefits.

• Patient Experience Team: 01896 826719 or patient.experience@borders.scot.nhs.uk
• Scottish Borders Council – 0300 100 1800 (Option 1) to find your local ‘What Matters’ Hub
• Borders Carers Centre – 01896 752431 or admin@borderscarers.co.uk
• Food Train – 01896 751750

• If you need this leaflet in another language, large print, audio or Braille, please tell a member of staff.

• If you have comments, compliments or concerns, please speak to the ward team or use the hospital’s
  feedback process. Your feedback helps us improve our service.