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Older People’s Services

Caring for older people.

This page was last updated: June 2nd, 2021

Our specialist team of doctors and nurses care for older and frail people in the region’s hospitals.

Our aim is to provide expert and compassionate care for older people who may have multiple conditions when they come into hospital and then return them to good health and their home as soon as possible.
At Royal Cornwall Hospital in Truro, we provide a frailty assessment service in the Emergency Department and Medical Admissions Unit and care for patients with a fractured neck or femur on the Trauma Unit.

Our Consultants and multidisciplinary teams provide specialist frailty care on wards at all our main acute hospitals and at community hospitals. There is a special acute older people’s ward at Royal Cornwall Hospital called Kerensa Ward where we see our frailest acute patients.

Our team is also involved in the care of stroke patients with a specialist service provided on the Phoenix Ward. You can read more about this service below.

The Cornwall Stroke Service

The Cornwall Stroke Service treats about 2000 stroke patients and 750 patients with transient ischaemic attacks (TIAs) every year.

Our service is spread across the Royal Cornwall Hospital, and two specialist Stroke Rehabilitation Units at Camborne Redruth and Bodmin Community Hospitals.

We have an experienced, multidisciplinary team of professionals including doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, dieticians, support workers and stroke care coordinators who work in liaison with our patients and their family, carers and GP.

If you suspect someone is having a stroke, call 999 immediately.

Symptoms of a stroke include facial weakness, arm and leg weakness and speech problems.
Find out more about the symptoms of a stroke on NHS Choices.

The Stroke Service Philosophy

  • To promote the physical, psychological, emotional, spiritual and social wellbeing of our clients, their relatives and significant others.
  • To provide our patients with optimum control over the health of their bodies and minds so that even after catastrophic disability, they may experience the highest possible quality of life, facilitating their dignity and treating them with respect at all times.
  • To provide our patients with the greatest possible opportunity to realise their full potential for recovery and, wherever possible, to enable the pursuit of valued activities at home and in the community.
  • To ensure that all members of the public experiencing stroke will have equal access to a fair service.
  • To observe the highest standards of personal and professional ethics and skilfully and conscientiously practice evidence-based care in line with the National Service Frameworks and the National Clinical Guidelines for Stroke.
  • To promote a nurturing environment that fosters personal and professional development and values the individuality of patients, team members, and colleagues.

Early Supported Discharge

Our Early Supported Discharge (ESD) stroke service provides early specialist rehabilitation at home to allow patients who have had a stroke to be discharged sooner.

The team includes a number of specialists to help patients regain as much confidence and independence as possible, including:

  • Physiotherapists – to help regain mobility and muscle control.
  • Occupational Therapists – to support you to be as independent and safe in tasks as possible.
  • Speech and Language Therapists – to help with any communication or swallowing needs.
  • Rehabilitation Technicians – to work with the therapists to progress rehabilitation.
  • Administrator – to support the team.

The team is based at Royal Cornwall Hospital (covering mid – West Cornwall) and Bodmin Hospital (Covering mid – East Cornwall).

The team provides specialist stroke rehabilitation to patients at home. This could be up to 45 minutes a day and five times a week if required. The ESD team will provide support for up to six weeks after discharge from hospital. Some people do not require all six weeks and are discharged sooner if their goals have been achieved. Some people require longer-term support, if this is the case, the ESD team will discuss how NHS community services or voluntary services could help.

You can contact the Early Supported Discharge team on 01872 253415, Monday to Friday between 8am and 4pm.

Stroke Research

The stroke service is heavily involved with the Royal Cornwall Clinical Research team, who carry out regular studies into how we can improve care and rehabilitation for stroke patients. Your care team will tell you if there are any relevant studies that you could get involved in. Find out more about taking part in clinical research here.

Referring a patient with suspected Transient Ischemic Attack (TIA)

We aim to see all TIAs within 24 hours of referral, unless the event was more than a week ago, in which case we aim to see the patient within a week. National and local guidance has removed the ABCD2 score from the referral pathway. Eventual diagnosis of a TIA does not correlate with the score and so some cases may not be seen promptly enough.

About 50% of our referrals are not a TIA. In order to maintain our service, we need to improve the referral process and make sure that patients who have not had a TIA are seen by the most appropriate service.

We are happy to see patients with minor strokes though the TIA clinic if they’re not candidates for urgent treatment (such as thrombolysis), and they are safe at home and able to swallow.

What is a TIA?

A transient ischaemic attack (TIA) or “mini stroke” is a brief episode of neurological dysfunction caused by a temporary disruption in the blood supply to part of the brain.

  • It’s transient – most only last minutes, although some can last hours. The WHO defines them as lasting up to 24 hours, which probably includes many minor strokes.
  • It’s ischaemic – so the symptoms are consistent with a disruption in blood supply to part of the brain.
  • It’s an attack – onset is sudden and maximal, so any episodes that spread or evolve are unlikely to be a TIA.

Why are TIAs a medical emergency?

About a quarter of patients who present with a stroke have had a preceding TIA and many of these TIAs happen in the preceding 24 to 48 hours. Around 10% of patients who have a TIA will have a significant stroke within a week.

What symptoms are likely to be caused by a TIA?

  • Unilateral weakness or sensory symptom of sudden onset
  • Amaurosis fugax
  • Communication problem of sudden onset such as dysphasia and dysarthria
  • Posterior circulation symptoms such as vertigo when due to vascular cause – this will usually be accompanied by other symptoms such as double vision

What symptoms are not likely to be caused by a TIA?

  • Blackout or transient loss of consciousness
  • Seizure
  • Isolated vertigo
  • Transient global amnesia
  • Isolated headaches
  • Sensory symptoms which spread from one part of body to the next
  • Progressive neurological symptoms

If these symptoms present, please consider an alternative referral pathway.

What should I do and what information should I give to the patient at the time of referral?

  • If symptoms have resolved give aspirin 300mg OD.
  • If the patient is a driver tell them not to drive until they’ve been seen in the TIA clinic.
  • Make sure the patient’s contact number is on the referral form so we can ring them to arrange their appointment.

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