Frailty Assessment

Assessment tools are used in the care planning process to build up a holistic picture of an individual’s needs. When all the details have been recorded an assessment can be made and suitable care and support can be identified. A few of the assessment tools are information from the individual such as diaries, observations, medical histories and checklists.

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(helpguide, 2012) Effective care for older patients requires an accurate assessment of the elderly's health status. Physical, psychological, social, and behavioral and health system factors may influence their health status. Functional health status includes: a) basic activities of daily living; dressing, feeding, bathing, toileting, transfer-moving inside and round the house, b) instrumental activities of daily living; shopping, laundry, cooking, housekeeping, taking medication, managing money, c) advanced activities of daily living; social activity, occupation, recreation. Cognitive function assessment includes: attention span, concentration, intelligence, judgment, learning ability, memory, orientation, perception, problem solving, psychomotor ability, reaction time, social intactness. (ispub, 2012)

The aims of those studies were to estimate the prevalence of frailty, and its ability to predict outcomes in older patients as short-term outcomes in

Assessment tools are a necessary part of everyday nursing care. They provide the nurse with measurable means of keeping inventory of a patient’s physical progression from shift to shift. Assessment tools like the Braden scale which assess the patient’s skin quality; along with the falls risk scale that assess how high the patient’s chances are for falling; are two common assessment tools used worldwide. Along with these physical assessment tools are an array of non-physical assessment tools used to evaluate anything from the patient’s coping skills to evaluating their stress level. Three popular ones are the

Group and Rehab Scale. Despite two of the listed five variables being common to the

Purpose: The purpose of the focus group is to gather information about educating community-dwelling older adults about frailty risk and that the feedback collected will help design an education program for older adults who may have decreased knowledge about frailty and frailty risk.

Frailty develops when an older adult experiences a stressor and is unable to achieve a normal homeostasis accompanied by a decrease in several physiologic systems over a period of time. With a decrease in different physiologic systems, homeostatic reserves become depleted, resulting in a minor stressor causing a change in health status that is disproportionate to the stressor. For example,

Frailty is a common clinical syndrome in older persons that carries an increased risk of poor health outcomes. Frailty has been described as “a physiologic state of increased vulnerability to stressors that decrease physiologic reservoirs, resulting from aging and decrease function of multiple physiologic organs (1). The overall prevalence of frailty in USA community dwelling aged 65 or older in the United States ranges 7-12%. The prevalence of frailty increased with age from 3.9% in the 65-74 age group to 25% in the 85+group, and was greater in women than men (8% vs. 5%) (2).

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The goal of the comprehensive geriatric assessment is to determine a patient’s medical status, functional capabilities and psychosocial status. These are then utilized to develop an overall plan for treatment and long-term follow-up to promote wellness and independence in maintaining or improving function and quality of life. It is a multidisciplinary approach. Open ended questions were utilized throughout the assessment to facilitate communication and interviewing. The focus of my “Healthy Aging Project” is VG, an 81 year old Hispanic female. She is a retired teacher who is widowed and lives alone in a small town that borders a major city. Her hobbies include word search puzzles, watching soap operas, participating in water aerobics and talking on the phone to her family. She is a patient with arthritis, diabetes, peripheral neuropathy and cardiovascular disease. The needs and goals identified by the patient are that she wants to remain at her optimal level of health, continue living independently and avoid further functional decline due to her diagnoses.

‘Frailty thy name is woman' emotionally refers to his mother 'Hamlet' (Act 1, Scene 2). While the term “frailty” has been around for a while, the use of it in a medical literature has only been evolving in the past 30 years. However, condition with similar meaning, was described back in 1914 in a publication “The Diseases of Old Age and their Treatment” (Nascher, 1914). In this publication Nascher describes a condition of his elderly patients as “senile disability” or “senile cachexia” manifesting in general physical weakness and mental impairments as a result of the aging process. Later, several authors use term “Failure to Thrive” while describing a multifactorial state of decline in elderly (Kimball et al., 1995; Robertson et al., 2004; Sarkisian et al., 1996). The search term “frail elderly” in PubMed.gov generated 8384 results indicating great interest by clinicians and researchers in this topic. However, despite the interest there is considerable uncertainty regarding the concept and definition of frailty (Bergman et al., 2007). Frailty is “one of those complex terms – like independence, life satisfaction, and continuity – that trouble gerontologists with multiple and slippery meanings” (Kaufman, 1994).

Reported Edmonton Frail Scale (REFS). The REFS derived from the Edmonton Frail Scale which defined frailty using the accumulation deficit model. The REFS evaluated ten domains for screening cognition function, general health status, functional independence, social support, medication uses, nutrition, mood, incontinence, self-reported performance. A total REFS score is 18, the scores of 12–18 is severe frailty, score 10–11 is moderate frailty, scores 8–9 is mild frailty, scores 6–7 is apparently frail and scores 0–5 is non-frail (Hilmer et al.,

at the time of your visit. We have divided the DGA in two parts, each with three

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