More than 2,200 older patients have been able to remain well at home since the start of Galway University Hospitals’ Frailty at the Front Door Service (FFD) commenced in 2021 – offering them targeted assessment and interventions in their domestic settings.

The FFD service is a team of Physiotherapists, Clinical Nurse Specialists, Occupational Therapists and Geriatricians who work with patients over the age of 75 who present to the Emergency Department with frailty; this usually arises after a fall or because of changes in a patient’s ability to complete everyday tasks.

The service uses a holistic and multi-disciplinary approach to help frail patients to avoid a hospital stay by intervening at the earliest point in the patient’s journey, that is, at the front door in the Emergency Department.

“Many older patients express a preference to recover from a health set back in their own home and a large part of the FDD service involves supporting the patient with a safety net of clinical services when they are discharged from the Emergency Department,” explained a spokesperson.

“We are seeing a large increase in the number of older patients attending hospitals, particularly among patients aged 75 and older, which has increased by almost 21% compared to the same period in 2019.

“It is crucial that older patients have alterative pathways to appropriate care outside of the acute hospital system, and this is what FDD strives to achieve,” they added.

Kathleen O’ Sullivan from Galway was referred to the Frailty team recently after she became unwell – and her son Ultan described the service as a hugely positive experience.

“The FDD team showed unbelievable compassion, respect, patience and understanding to my Mum and her needs,” he said.

“Prior to Mum arriving home from hospital, the Frailty therapists came to her home to assess the space and to see what equipment would be required to allow her recover from her set back.

“As a direct result of the Frailty Team’s interventions, together with the other great local health services, Mum has made a full recovery and regained her independence to continue to live with dignity in her own home,” he added.

Some of the key aspects of the FDD service are continuity of care and follow up, this year the Frailty team has supported discharge directly to home in over 60% of frailty cases presenting to the Emergency Department.

This involves working with colleagues in Galway’s Integrated Care Programme for Older Persons to ensure that patients can safely recover at home with access to the appropriate clinical specialists should they need it.

Orla Sheil is Senior Occupational Therapist in the FDD service, she describes some of the work carried out by the team.

“Early assessment means we find out what’s important to our patients and what their needs are and early intervention means we find ways to support their safe recovery at home,” she said.

“This approach has really significant outcomes both in terms of patient flow in the hospital setting leading to shorter length of stay and also enhances mobility, recovery and independence for our frailty patients.”

Pictured: Patient Kathleen O Sullivan in her home in Galway with GUH Frailty Team’s Therapy Assistant, Patricia Duffy.