Frailty

Question 1

how is frailty defined?

Answer 1

Distinctive health state which is related to the ageing process in which multiple body systems gradually lose their inbuilt reserves

• Diminished strength, endurance, and reduced physiologic function
• Increases vulnerability for dependency and/ or death
• 10% of those over 65 have frailty, Rises to 50% by 85

Question 2

How is frailty identified?

Answer 2

• Looking for signs like unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, low physical activity
• Using the electronic frailty index
  
  • calculation of a frailty score to identify older people with mild, moderate and severe frailty
• Use of PRISMA-7 questionnaire, gait speed etc
• Focus on frailty syndromes - falls, immobility, delirium, incontinence, susceptibility to side effects

Question 3

why is frailty important to identify?

Answer 3

• Identifying frailty allows for prevention, progression or potentially reversal of frailty
• Opportunity to suggest improvements into their lives
• Exercise programmes, nutrition review, medication review

Question 4

how can those identified as frail be supported in the community?

Answer 4

• MDT care
• comprehensive assessments
• coordinate acre
• home-based care services
• falls prevention
• STOP-START use
• nutrition assessment
• advanced care planning
• respite care etc for carers

Question 5

how can those identified as frail be supported in an inpatient setting?

Answer 5

• comprehensive assessments
• MDT
• rehab programmes with physio and PT
• STOPP START
• nutritional assessment
• falls prevention
• manage delirium
• pain assessment
• psychological support
• communicate with family
• initiate discharge planning and aftercare