Frailty and deconditioning on the acute take

It is well known that older patients have a higher incidence of adverse hospital outcomes, such as inpatient falls, delirium and longer lengths of stay, and that older people are likely to become deconditioned during their time in hospital. It is often felt that deconditioning occurs as a consequence of a prolonged stay; however, the adverse effects of immobility can occur within hours of arrival into urgent care. Hospital-aquired deconditioning is in fact a multi-systemic syndrome that manifests in a number of ways outside muscle weakness, including delirium, healthcare-associated infection, new incontinence and falls, all of which can worsen outcomes for patients and lead to prolonged hospital stays. We outline strategies to embed preventing deconditioning into the care of older patients who present to the emergency and acute medical unit in order to avoid unnecessary harm and support patients to maintain their independence.