Scoring "Frailty" - The Ultimate Bitesize Guide
Kirsten Protherough
Delivering Frailty Training for Care Providers | Supporting Older Adults 65+ with Home-Based Holistic Health Care | Helping 40+ Achieve Healthier Aging
Why understanding "Frailty" is important for proactive personalised care and to prevent unplanned emergency admission to hospital
For years I have worked with older adults living with frailty in community hospitals. I am now passionate about bridging the health and social care divide by providing high quality education for domiciliary care agencies.
I have seen the effects of long hospital stays in patients living with frailty and it is my mission to help carers help their clients avoid hospital by:
In this article I will walk you through common causes of illness and delirium in older adults living with frailty.
Using a highly memorable PINCH ME mnemonic your carers will remember!
It includes a typical case study at the end. Feel free to share with your team.
#1: Why recognising illness in frailty is important
In the world of both informal and formal caregiving, recognising when a client is unwell is crucial. A key concept caregivers must be familiar with is frailty.
Frailty is a common condition among older adults and those with multiple chronic conditions, and it often presents in ways that can be subtle and easy to overlook.
Understanding the signs and common presenting conditions associated with?frailty can empower caregivers to provide timely and appropriate care.
#2: What is the definition of frailty?
Frailty is now being used more as a diagnosis, rather than just a descriptive tool.
Frailty is a health state that describes the gradual loss of the body's reserves as people age. It's characterised by a number of factors, including: Reduced muscle strength, Fatigue, Slow walking speed, Low energy, and Vulnerability to adverse health outcomes.?
Frailty can make people more likely to experience sudden increase in dependency in response to small events, such as a change in medication or environment. It can also increase the risk of falls, disability, hospital admission, and long-term care.?
Frailty is more common in older people, with around 10% of people over 65 affected, and up to 50% of people over 85.?
The Clinical Frailty Scale? (also known as the Rockwood) is a tool that can? help caregivers assess the degree of frailty in their? clients.
This tool considers various factors, such as? the degree of assistance a person over the age of 65? requires in carrying out their activities of daily living.
Why score "Frailty"?
The reason to score frailty is that it enables you to provide more personalised care based on the degree of frailty.
For example:
These care plans may include a RESPECT form or equivalent and what "Matters Most" to your clients which may centre around things that help them enjoy their life and often avoiding long hospital admissions is a preference.
#3: Can your team recognise illness in frailty?
Clients living with frailty often present with conditions that may not be immediately recognisable as signs of illness. Here are some common presenting conditions to be aware of:
Falls and Mobility Issues
Unintentional Weight Loss
Fatigue and Low Energy
Cognitive Decline and Delirium
Chronic Pain
Polypharmacy AKA "Too many tablets!"
Frequent Infections
Recognising these common presenting conditions in clients living with frailty is the first step in ensuring that they receive the appropriate care and support they need.
Caregivers can:
Encourage and support activities and lifestyle?choices, such as balanced nutrition, regular?physical activity, and social engagement, to? improve overall well-being. In conclusion, understanding frailty and its common? presenting conditions can significantly enhance?the quality of care provided to clients.
By adopting?a proactive approach and confidently escalating?concerns and findings to healthcare providers,?caregivers can help manage the complexities of?frailty, ensuring that their clients live healthier lives?and safely avoid hospital admissions.
?#4: PINCH ME a helpful mnemonic to identify causes of delirium and illness in frailty#
Mrs. Smith, an 82-year-old woman receiving domiciliary care, was usually alert and oriented. However, her caregiver noticed a sudden change in her behaviour—Mrs. Smith became disoriented and agitated.?
This is termed “hyperactive” delirium as there is increased agitation. The other type of delirium is “hypoactive,” where a person becomes more sleepy than usual (e.g., they may not want to get out of bed).?
Using the PINCH ME?mnemonic, the caregiver assessed the potential causes of delirium:?
Based on this assessment, the caregiver contacted Mrs. Smith’s healthcare provider, provided the background of the situation and the urine sample, and a urinary tract infection was confirmed and treated. Codeine also caused constipation which in turn can increase the risk of a urinary infection.
Her pain medication was adjusted, and Mrs. Smith’s "hyperactive delirium" resolved quickly, allowing her to return to her usual state of health and baseline. The effect of the codeine was documented in her care plan, and alternatives should be considered in the future.
#5 Transform Your Frailty Care Through Expert Training
The invaluable PINCH ME mnemonic for recognising causes of delirium is just one example of the accessible tools I use to teach frailty.
80% of successful care improvements come from investing in staff expertise, and it’s no surprise when empowered carers make better decisions for clients every day.
Is it time to rethink your approach to frailty training?
Why is Upskill for frailty unique?
?? Unsure where to go from here? contact me to learn more:?
References:
Managing Director of ATICC LTD - Mental Health & ligature consultancy.
1 个月Very informative, thanks