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University Hospitals Dorset NHS Foundation Trust

The Day Hospital

What we do

The Day Hospital is based at Christchurch Hospital and provides specialist assessment, treatment and rehabilitation for older people that aims to:

  • Maximise the health and independence of older people as far as possible for that individual
  • Assist primary care and social care services with the treatment and management of people with complex conditions that are associated with age
  • Avoid preventable hospital admissions and facilitate early supported discharge

Who we are

The services at the Day Hospital are provided by a range of health professionals who all have an input into the care of patients. This includes doctors, nurses, physiotherapists, occupational therapists, speech and language therapists and dieticians.

How to access our services

Patients can be referred to the Day Hospital by a primary care professional (such as a GP), a hospital clinician or a some one in social care. There are some services that patients can also self-refer.

Becoming a patient at the Day Hospital

Once you have been referred to the Day Hospital you will receive an assessment by a range of health professionals, including doctors and therapists. After the assessment we will discuss the findings with you and treatment will be offered where appropriate. If you are happy with the suggested treatment we will put a plan together that is specifically for you and your needs.

On referral to the Day Hospital you will receive an assessment on:

  • The problems that you, your carer or relative have identified
  • Your general health
  • Medical history
  • The medicines that you take
  • Function, independence and safety at home, including the need to increase or decrease your social care
  • Your mobility; muscle power, range of movements, balance and stamina
  • Communication
  • Memory
  • Psychological aspects, including mood, anxiety and depression
  • Current lifestyle, including social interaction and use of leisure time

Our services

About the service

The Falls Prevention service aims to identify and treat the reversible causes of falls. When it is not possible to prevent the person from falling again, we look at ways to reduce the impact of further falls.

What we do

Treatment

Each patient is assessed either in the Medical Outpatient Clinic or the Specialist Falls Clinic. Osteoporosis and bone health is an integral part of the falls service. The bone health of all patients who have fallen is assessed and treatment provided (in line with NICE and Royal College of Physicians guidelines)

Each patient is assessed either in the Medical Outpatient Clinic or the Specialist Falls Clinic. Osteoporosis and bone health is an integral part of the falls service. The bone health of all patients who have fallen is assessed and treatment provided (in line with NICE and Royal College of Physicians guidelines)

The Specialist Falls Clinic is run by a Consultant Geriatrician supported by members of the Day Hospital team. They assess recurrent or single unexplained falls with injury and/or abnormal gait and balance.

Assessment

Following assessment the most appropriate treatment for the patient is provided. This could include:

A rehabilitation programme for fallers

A risk reduction programme for fallers

Community Falls Team

Osteoporosis and Bone Health

The rehabilitation programme for fallers includes individual treatment sessions and/or balance groups to treat the reversible causes of falls. The programme is evidence based and follows the guidelines issued by NICE and the Royal College of Physicians.

The Risk Reduction Programme for Fallers provides the patient with ideas and equipment to reduce the impact of any further falls. Their environment and other external factors area assessed and modified to reduce the likelihood of further falls.

The Community Falls Team is a team of different health professionals who assess and treat patients in their own home. The patient has access to all other elements of the falls service as appropriate. The team runs community based balance groups and refers patients on to community based exercise and leisure opportunities.

About the service

A high number of older people who are referred to the Day Hospital have some dizziness. This can lead to the risk of falls and can also limit the patient’s ability to take part in a rehabilitation programme.

What we do

We use the following approaches:

Medical investigation of dizziness and managing any treatable causes

Assessment for benign postural vertigo and treatment of the positive signs using a particle re-positioning technique

An exercise programme to desensitise the patient to the effects of dizziness, enabling them to cope more effectively with the symptoms

Psychological acceptance of untreatable vertigo and anxiety management

About the service

The Day Hospital has occupational therapists, physiotherapists and nurses who are experts in the treatment and rehabilitation of people following a stroke.

Stroke patients who need ongoing rehabilitation to progress their treatment can attend the Day Hospital or be treated at home. We also see long term stroke patients whose care is reviewed and further rehabilitation provided to improve or maintain independence in the community.

Once a patient has been discharged from the Day Hospital patients are able to contact the unit if they feel that further help is required and a self-referral is possible.

About the service

A small team of therapists provide specialist community follow-up for patients needing intervention from one or team different health professionals, e.g. Occupational Therapy and Physiotherapy.

Patients using this service need complex intervention including vocational and physical rehabilitation to assist in returning to work or meaningful activity.

What we do

The team sees predominantly younger adults under the age of 65 with a range of neurological problems. They are based at the Day Hospital but will see patients at home or as an outpatient, depending on the needs of the patient. Ongoing medical support is provided through the GP and neurologist when needed.

The service is provided Monday to Friday 8.30am to 4.30pm and does not provide rapid response intervention.

About the service

The Day Hospital has occupational therapists, physiotherapists and nurses who are expert in the treatment and rehabilitation of people with Parkinson’s Disease.

Referrals to this service are through the hospitals’ Medicine for Elderly Consultant and his team.

What we do

All patients newly diagnosed with Parkinson’s Disease are invited to attend a lifestyle advice clinic which is run by a team of health professionals, including a speech and language therapist.

The team provides advice on maintaining mobility, functions and communication to the highest level possible for the patient.

Other treatments include:

Early stage exercise group

Home visits by an occupational therapist

Individual treatment and rehabilitation programmes

Late stage exercise group

Palliative care advice and management in the late stages of the disease

Psychological acceptance to the disease process

About the service

Older people referred to the Day Hospital for rehabilitation are often found to be suffering from a range of bereavements. As well as losing partners and friends, they may also be losing function and independence. Having falls, and the fear of further falls, can limit people’s confidence and result in further loss of function.

We know that our rehabilitation programmes are not going to be successful if people are experiencing levels of depression or anxiety

What we do

To help combat some of the psychological issues that our patients may have, we have introduced the following:

Anxiety management programme

Brief focused psychotherapy for anxiety and depression which is a form of Cognitive Behavioural Therapy

This kind of intervention is proven to have a beneficial impact on an individual’s physical function.

This service is available to patients referred to the Day Hospital as part of their rehabilitation treatment. We are unable to accept patients for psychological treatments only.

About the service

The Rapid Assessment Clinic is a new service that provides next day assessment for older people who have come into hospital via the Emergency Department. The OPAL Team (based in the ED) refers older patients to the Day Hospital for assessment and treatment to avoid unnecessary admissions to hospital.

The clinic is based at the Day Hospital and is led by a Consultant Geriatrician. The service provides assessment, investigations, treatment and rehabilitation to address in more depth the acute and longer term needs of older people.

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