Offering elderly people a 'cwtch' after a fall 'cuts hospital admissions' says health board

Emergency nurse practitioner, Debra Clee, created the new education programme. Credit: Swansea Bay University Health Board

Health professionals in Wales are giving elderly people a "cwtch" after a fall in a bid to keep them out of hospital.

But whilst a hug may be part of it, this isn't a cwtch in the Welsh sense of the word.

The new approach outlines a list of ways on how to handle the situation when an elderly person has taken a tumble.

Traditionally, you are encouraged not to move someone if they have fallen, or give them any food or drink until an ambulance arrives.

However this view has now changed with Swansea Bay University Health Board highlighting growing evidence to suggest leaving someone where they fell can lead to serious physical problems.

It's hoped the new system of dealing with a fall will avoid the need to call for an ambulance unless necessary. Credit: Swansea Bay University Health Board

This can go on to cause other issues such as pneumonia or dehydration, which occur separately to the fall itself.

With ambulance waiting times continuing to rise, leading to some people waiting hours, the current practice is causing more problems says the health board.

The new CWTCH system outlines a five-point plan to help deal with a fall:

C - Can you move them?

W - Will it harm them? For example by causing any new neck or back pain?

T - Treat the wounds by dressing them or offering pain relief

C - Cup of tea, most elderly people eat or drink after a fall

H - Help, know when to call an ambulance or a doctor

The system was developed by Debra Clee, an emergency nurse practitioner in Older People's Assessment Services (OPAS) at Morriston Hospital in Swansea.

Ms Clee explained: "We are trying to change the narrative out there and say that if they can be moved then we need to move them.

"We are finding that they are being admitted, not because of the fall but because of the long lie, as we call it.

The Cwtch system has already been rolled out in nursing homes across Swansea. Credit: PA

"When you hear stories about someone never recovering from a fall, often it's not the injury itself but being left on a hard surface for a very long time. This can cause acute kidney problems, it can give them pneumonia, it can cause muscle tissue to break down.

"If they are not being given anything to eat or drink they can become dehydrated. By the time they come to us they are not fit for surgery, if it's needed, and are quite unwell", Ms Clee added.

The Cwtch system has already been rolled out in nursing homes across Swansea and will soon be introduced to those in Neath Port Talbot.

Ms Clee acknowledged that there are still circumstances where the patient should not be moved, but added they could still be offered painkillers, food or drink.

"In many cases they can be helped up, maybe given a cup of tea and put into bed with some paracetamol.

"Within a few hours or by the next morning they could be up and about again. If necessary, a GP can be called to see them or they can be taken to the minor injury unit or to us here in OPAS.

"Very often this can be done by car. But if they are left on the floor for hours then they will definitely need an ambulance and quite likely admission to hospital", Ms Clee explained.