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.

(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)

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

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 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).

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).

They make sure that they give their staff clear instruction on how to deal with cases of heart failure. The specialty team consist of heart failure nurses and general practitioners that reach out to the community. Their priority goal is patient monitoring; which consists of a clinical assessment of functional capacity, fluid status, cardiac rhythm, cognitive status and nutritional status (Kirk, 2011). As well as a review of medication, including the need for changes and charting of possible side

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.

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

Most of the mechanisms that cause aging are the same as those that cause disease process (Gladyshev, & Gladyshev, 2016). In fact, aging itself is a risk factor for many diseases (Gladyshev, & Gladyshev, 2016). Therefore, it is better to treat the condition of aging which ultimately treats age-related diseases, at the same time (Gladyshev, & Gladyshev, 2016). One method of evaluating aging and the progression of age related disease is by assessing their effect on the patient's functional abilities (Roedl, Wilson, & Fine, 2016). The functional assessment can be segregated into three levels, basic, instrumental and advanced activities of daily living (Roedl et al., 2016). The basic level are the activities needed for independence such as toilet, bathing, feeding, dressing, incontinence and transferring (Roedl et al., 2016). The instrumental level is needed to have their own household such as grocery shopping, housework, home repair, laundry, the ability to navigate some form of transportation, be able to use a telephone, prepare meals, take medications, and handling their finances (Roedl et al., 2016). The advanced functions are the highest and include recreational, societal, family and occupation (Roedl et al., 2016). Specific test might include vision, hearing, mobility, depression, and cognition. The goal is to maintain independence for as long as possible. Function has an inverse

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.

Advancing age is associated with a higher prevalence of both acute and chronic disease and an increasing risk of becoming functionally dependent. Roughly, 5.3% of adults between the ages of 65 and 75 require assistance with basic activities of daily living (bathing, dressing, walking, use of the toilet, and transferring from bed to chair). Slightly fewer than 6% require assistance with instrumental activities of daily living (cooking, shopping, use of the telephone, household chores, and handling household financial matters). Functional dependence greatly increases the need for both acute and chronic health care and amplifies the risk of institutionalization. A number of excellent reviews address problems and issues in assessment of older

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

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