A cwtch solves everything

A cwtch solves everything

For the Welsh amongst our readers, little explanation is necessary, we already know a cwtch (meaning a cuddle in Welsh) fixes everything, but how can a Welsh hug help the elderly after a fall?

Traditionally, we’ve been advised not to move someone after a suspected fall, or not to offer them food or drink until the ambulance arrives. However, a new approach is now being advised.

Sadly, ambulance waiting times are currently longer than anybody would like. The potential damage caused to an elderly person by the ‘long lie’ alone could lead to a necessary hospital admission, whereas the original fall itself may not have done so.

^{Credit: Swansea Bay University Health Board.}

Debra Clee, an Emergency Nurse Practitioner at the Older Peoples Assessment Services (OPAS) at the Morriston Hospital in Swansea, has developed a new CWTCH system, which has been rolled out in nursing homes in the Swansea area with overwhelmingly positive feedback.

So, what is CWTCH?

• Can you move them?
• Will it harm them (any new neck or back pain)?
• Treat (wounds/pain relief).
• Cup of tea (in most cases they can eat or drink).
• Help (when to call).

Debra explains the benefits of the CWTCH system:

“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.

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.

We are going into nursing homes rather than residential homes, as they have qualified staff who can assess the patients.

There are circumstances when they should not be moved. But even then, we say you can give them painkillers and something to eat 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.”