Emergency departments in England do not meet basic care needs of frail older people

A new study shows that the English healthcare system does not do enough for the care of frail older people.

Researchers from the University of Leicester and from University College of London found that clear and timely explanations of what’s happening and what’s wrong and a treatment with dignity and respect seem to be missing.

The research interviewed 24 people aged 75 and over who were at least mildly frail and with recent experience of treatment, as well as 16 carers.

Older patients and carers described attendances for 28 people across three hospital sites in England between January and June 2019.

Feedback showed that the interviewees were very reluctant to be taken to an emergency department, often because of previous negative experiences, and fear they wouldn’t come out of the hospital alive, and that they felt helpless when attendance couldn’t be avoided.

The time spent in emergency departments was found “dominated by negative experiences relating to very basic issues such as a lack of help with eating, drinking, toileting and discomfort from long waits on hard trolleys”.

‘We urgently need to rectify this’

In a linked editorial, Mary Dawood of Imperial College NHS Trust said: “To our shame, these interviews have drawn into sharp focus just how disenfranchised and marginalised frail older people feel when using our services.

“Unlike younger, fitter patients, they are less able or inclined to complain or voice dissatisfaction when their needs are not being met.

“We urgently need to reflect on and rectify this, redesigning our services for all our patients, keeping in mind the needs of older people, although similar, are much more urgent and the ramifications of not getting it right, far greater.”

Limitations of the study included a small number of participants.