By Crystal Welch, HHQI RN Project Coordinator
What comes to your mind when you think of people who are frail? Do you think of the condition of being weak or delicate? Or maybe you think of those who are elderly, perhaps those with functional deficits or difficulty getting around? Or you may think of those people who have multi-morbidities or are experiencing dementia? All of these conditions can be used to describe the frail and with a population of increasingly aged adults, the likelihood of a loved one, family, friend or acquaintance becoming frail is a strong probability.
Recently, my family experienced a situation that most of you reading this blog post may have faced as well. The scenario is this: an older-aged family member, who appeared to be robust and healthy, experienced a minor fall which surprisingly resulted in him never regaining full function following a hospitalization Meanwhile, the elderly and frail caregiver of the family member described above was facing a decision to proceed with an invasive procedure. This was made difficult because although they felt they may benefit from the procedure, the decision to proceed was overshadowed by her own frailty and the risk of potential procedure-related complications.
Many times home health patients and their families are facing similar circumstances. What can we do to intervene as health professionals? How can we improve outcomes for our frail patients? And how can we recognize when palliative care is appropriate? Many times, patients who are frail have subtle hints of symptoms that can be easily overlooked while others are clearly in a state of gradual but unrelenting functional decline. Frail older adults are vulnerable and aren’t able to adapt to the stress of acute illness or trauma.
Something to consider is implementing a frailty assessment. To assist in the assessment, you may want to reference this frailty scale.
HHQI had the great opportunity to have Margaret Sayers, MSc, serve as a guest speaker on a presentation that featured the topic of frailty. Margaret is a Geriatric Nurse Practitioner with decades of clinical and administrative experience, and is passionate for the challenges and complexities of providing both beneficial and desired quality health care to the most vulnerable. She remains focused on the slope of decline in the elderly as their frailty increases.