Needs in frailty
The Canadian Study of Health and Ageing describes frail people as below (category 4,5,6 and 7).
| Category | Definition |
|---|---|
Category 1 |
Very fit (the most fit) |
Category 2 |
Well (without active disease) |
Category 3 |
Well, with treated (well- controlled) co-morbid disease |
Category 4 |
Apparently Vulnerable –although not frankly dependent, these people commonly complain of being “slowed down”, or have disease symptoms. |
Category 5 |
Mildly Frail – with limited dependence on others for instrumental activities of daily living. |
Category 6 |
Moderately Frail – help is needed with both instrumental and non - instrumental activities of daily living. |
Category 7 |
Severely Frail – completely dependent on others for the activities of daily living, or terminally ill. |
(From the CSHA Clinical Frailty Scale, CMAJ)
Other studies have used a frailty index, obtained by comprehensively assessing physical, psychological and mental health and function.
In the assessment of a frail elderly person and their needs, all factors need to be taken into consideration including:
- Medical history and present state of health.
- Current medications and side effects/ interactions.
- Social circumstances and level of support needed (for example, social isolation, having to give up driving).
- Current level of functional ability (ability to self- care, and to get about).
- Physical and mental state, including musculo-skeletal, cardiovascular, cognitive, balance and gait, and nutritional status.
A multidisciplinary approach with information from all professionals (doctor, physiotherapist, occupational therapist, carers, nurses and dietician) involved with the person is important in order to get an overall view.
Frailty is common in older people and may be an indication of future prognosis (gradual decline and death) but the process can be reversed by treating those conditions, which are not irreversible and which are a contributory factor to frailty. For example, loss of muscle mass can be reversed by an exercise programme, which builds muscular strength. Poor eating habits may be changed and anaemia can be treated by the appropriate medication.
