For patients with frailty, dementia or delirium, avoidable admission to hospital can be detrimental to both physical and mental health. Patients lose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital. In addition, change of environment can worsen cognitive and behavioural issues in those with dementia or delirium. For some patient\u2019s admission to hospital is still the most appropriate course of action but this document outlines alternatives sources of support and treatment available to prevent this where possible.<\/p>\n\n\n\n
Frailty Assessment<\/strong><\/p>\n\n\n\n Across Lothian, it is recommended you use the Rockwood Clinical Frailty Scale<\/strong><\/a> in all Medicine of the Elderly referrals and your clinical practice.<\/p>\n\n\n\n JH & JB 26\/6\/26<\/strong><\/p>\n\n\n\n Please see this PDF on all referral pathways for MOE patients in East Lothian<\/a><\/p>\n\n\n\n Where referral forms are mentioned these can be found under the Resources and Links section of this page.<\/p>\n\n\n\n UPDATE JUNE 2026 RE MOE-LED IV THERAPIES (blood transfusions and IV therapy): These services are not currently able to be offered at ELCH. East Lothian patients requiring this service should be escalated to RIE if required<\/mark><\/strong><\/p>\n\n\n\n (Please note this will not affect those already having treatment delivered from Haematology in the IV therapies satellite unit, or those where the treatment is arranged via their GI consultant directly with endoscopy)<\/p>\n\n\n\n For MOE Advice and OPD in East Lothian the pathways are:<\/p>\n\n\n\n FOR ADVICE ONLY: East Lothian Community Hospital >> Geriatric Medicine >> Geriatric Medicine Advice<\/p>\n\n\n\n FOR OUTPATIENT APPPOINTMENT: East Lothian Community Hospital >> Geriatric Medicine >> Basic Sign Referral<\/p>\n\n\n\n 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. <\/strong><\/p>\n<\/div><\/div>\n\n\n\n Clinical Frailty Scale (Rockwood)<\/a><\/strong><\/p>\n\n\n\n Frailty Poster<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" Information For patients with frailty, dementia or delirium, avoidable admission to hospital can be detrimental to both physical and mental health. Patients lose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital. In addition, change of environment can worsen cognitive and behavioural issues in those<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[310],"class_list":["post-4149","page","type-page","status-publish","hentry","category-moe-east-lothian"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" MoE East Lothian<\/a>","rttpg_excerpt":"Information For patients with frailty, dementia or delirium, avoidable admission to hospital can be detrimental to both physical and mental health. Patients lose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital. In addition, change of environment can worsen cognitive and behavioural issues in those","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4149","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\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4149"}],"version-history":[{"count":11,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4149\/revisions"}],"predecessor-version":[{"id":28850,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4149\/revisions\/28850"}],"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=4149"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<\/ul>\n
Who to refer:<\/h4>\n\n\n\n
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Who not to refer:<\/h4>\n\n\n\n
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