All staff working in acute medical units (AMUs) will be familiar with the increasing number of older people living with frailty who require access to acute care.
The AMU provides a key role in identifying frailty, along with urgent and important issues that need addressing. When these are assessed accurately and holistically, patient outcomes will improve. Accordingly, acute medical teams need to possess the knowledge and skills, and demonstrate the appropriate behaviours, for managing older people living with frailty.
Older people are major users of acute care; the AMU is a key area for initial decision making, and for education and training relevant to older people. Different models will be suited to different hospitals, but all need to be able to initiate CGA within the AMU and to have strong links with community health and social services.
Geriatricians supporting the AMU will be able to help to identify older people who may be safely managed in the community, improving patient outcomes and reducing hospital bed-days.
The principles of managing frail older patients acutely in urgent care settings during the pandemic remain unchanged. However, our addendum draws attention to some COVID-19-specific issues.