What?
The term "frailty" comes up daily in primary care, there are even automatic notifications when you open a patient's record that inform you of their frailty status. I have a vague idea of what frailty means, but on stopping to think about this, I realise that I understand frailty in layman's terms rather than in clinical terms. This is something I would like to improve on, as I realise I don't know what clinical frailty means, what is the difference between mild, moderate and severe frailty, and what does that mean for service users?
So what?
By understanding what frailty means for a service user, is it possible to tailor the advice and exercise I can give them so they are more manageable, appropriate and helpful. It will also help in making every contact count, by making sure they are receiving an appropriate level of care for their needs, signposting them to relevant community services, and recognising early signs of modifiable factors that reduce quality of life, such as social isolation, deconditioning, or cognitive impairment.
Now what?
I found an e-Learning for Health course that helped me to address the gaps in my knowledge regarding frailty. It helped me to distinguish between healthy ageing and increasing frailty, and that frailty is considered an LTC or health state in its own right. I also learned about the different classifications of frailty and their relevance to different sectors of healthcare, in that the eFI is used more in primary care to help signpost patients to community services, and that the CFS is used more in secondary care in helping to establish an appropriate care plan once a patient has been admitted.
I feel I am better able to classify frailty, and notice changes that may influence its severity, by recognising that the main five symptoms are:
-Falls
-Decreased mobility
-Confusion/Delirium
-Incontinence
-Susceptibility to side effects of medicines
These symptoms come up daily in primary care, and noticing changes early might help to steer a service user's care towards more appropriate pathways for their changing needs.
One thing that came up in the learning activity that I was quite surprised by was the significance of delirium. I had no idea that it was associated with such a high rate of mortality, or that it could present with hypoactivity as well as hyperactivity. Whilst its quite unlikely I would see acute delirium in primary care, I now feel more aware of its significance should my career take me towards a secondary care role, and also feel better able to recognise signs of confusion and realise that they should not be brushed off as attributable to other conditions or advancing age.