{"id":19514,"date":"2024-05-22T10:55:54","date_gmt":"2024-05-22T09:55:54","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=19514"},"modified":"2025-12-12T11:17:29","modified_gmt":"2025-12-12T11:17:29","slug":"moe-midlothian","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/moe-midlothian\/","title":{"rendered":"MoE Midlothian"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Information<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For patients with frailty, dementia or delirium, admission to hospital can be detrimental to both physical and mental health.&nbsp; Patients lose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital.&nbsp; In addition, change of environment can worsen cognitive and behavioural issues in those with dementia or delirium.&nbsp; For some patients, admission to hospital is still the most appropriate course of action but this document outlines a range of community-based services that provide assessment for frail elderly and offer alternatives to admission or alternative admission pathways for suitable patients.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Frailty Assessment<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Across Lothian, it is recommended you use the <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/MoE-HatH-Rockwood-Clinical-Frailty-Scale-April-2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Rockwood Clinical Frailty Scale&nbsp;<\/strong><\/a> in all Medicine of the Elderly referrals and your clinical practice.<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">Please see this PDF on <strong><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/MOE-ML-REFERAL-PATHWAYS-DEC-25.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/MOE-ML-REFERAL-PATHWAYS-DEC-25.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">all referral pathways for MOE patients in Midlothian<\/a>.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Where referral forms are mentioned these can be found under the <strong>Resources and Links<\/strong> section of this page.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Falls, frailty syndromes including dizziness<\/li>\n\n\n\n<li>Weight loss in frail older patients i.e. clinical frailty score &gt;4<\/li>\n\n\n\n<li>Multiple\/complex symptoms in frail<\/li>\n\n\n\n<li>Single symptom suggestive of malignancy if frail (consider if single organ specialty referral more appropriate especially if clinical frailty score &lt;4)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Iron deficiency anaemia (single issue) \u2013 should be referred to GI<\/li>\n\n\n\n<li>Memory loss only \u2013 should be referred to Midlothian Older People\u2019s Mental Health Team: https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/mentalhealthadult\/older-peoples-mental-health\/olderpeoplesmentalhealthmidlothian\/<\/li>\n\n\n\n<li>Incontinence \u2013 consider continence nurse \/ DN referral<\/li>\n\n\n\n<li>End of life support \u2013 palliative care team unless require community bed in which case please refer via Midlothian Patient Flow Team (see above)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>ALL the above do not preclude the referral being appropriate \u2013 clinical judgment is required. We are more than happy to discuss referrals\/give advice.&nbsp;<\/strong><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SPOA-referral-form-JAN25.docx\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SPOA-referral-form-JAN25.docx\" target=\"_blank\" rel=\"noreferrer noopener\">SPOA ML REFERRAL FORM V1<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Community-Referral-Adult-SLT-2018-V1.doc\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Community-Referral-Adult-SLT-2018-V1.doc\" target=\"_blank\" rel=\"noreferrer noopener\">Community Referral Adult SLT 2018 V1<\/a><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/MoE-HatH-Rockwood-Clinical-Frailty-Scale-April-2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Clinical Frailty Scale (Rockwood)<\/strong><\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/FRAILTY-POSTER.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/FRAILTY-POSTER.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Frailty Poster<\/a><\/strong><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Information For patients with frailty, dementia or delirium, admission to hospital can be detrimental to both physical and mental health.&nbsp; Patients lose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital.&nbsp; In addition, change of environment can worsen cognitive and behavioural issues in those with<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[1103],"class_list":["post-19514","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-moe-midlothian"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/medicineofelderlygeriatrics\/medicine-of-the-elderly-services\/https-apps-nhslothian-scot-refhelp-moe-midlothian\/\" rel=\"tag\">MoE Midlothian<\/a>","rttpg_excerpt":"Information For patients with frailty, dementia or delirium, admission to hospital can be detrimental to both physical and mental health.&nbsp; Patients lose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital.&nbsp; In addition, change of environment can worsen cognitive and behavioural issues in those with","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/19514","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=19514"}],"version-history":[{"count":4,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/19514\/revisions"}],"predecessor-version":[{"id":25901,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/19514\/revisions\/25901"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=19514"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=19514"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}