1: Frailty Flashcards
Define frailty
State of increased vulnerability to poor resolution of homeostasis after a stressor event
What does frailty mean
Individuals can appear with straightforward symptoms with underlying complex frailty syndromes
What are the 5 frailty syndromes
Delirium Incontinence Immobility Falls Susceptibility to side effects of medications
How is frailty meant to be prevented
All GPs should complete an electronic frailty index for patients >65y
What is used in practice to assess frailty
Rockwood Clinical Frailty Score
What is 1 on the Rockwood clinical frailty score
Robust, active, energetic and motivated. Fit for their age
What is 2 on the Rockwood clinical frailty score
No active disease symptoms, but less fit than 1.
What is 3 on the rockwood frailty score
Medical problems well controlled but not regularly active
What is 4 on the rock wood clinical frailty score
Symptoms limits activity
What is 5 of the rockwood clinical frailty score
Slowing, need help with ADL
What is 6 on the rockwood clinical frailty score
Need help with outdoor actives, possibly stairs and bathing
What is 7 on the rockwood clinical frailty score
Completely dependent for personal care
What is 8 on the rockwood clinical frailty score
Completely dependent and nearing end-stage life
What is 9 on the rockwood clinical frailty score
< 6 months
What may be used in primary care to assess frailty
Gait speed Timed up and go test Grip strength PRIMSA 7 Rockwood clinical frailty score
How are frail patients managed
Comprehensive geriatric assessment
What is a comprehensive geriatric assessment
Clinical management strategy that gives a framework to deliver interventions which address issue for the patient
What are 4 indications of the comprehensive geriatric assessment
- Elderly person presents to GP with frailty syndrome
- Discharged from hospital with a frailty syndrome
- Community team learns of frailty
- Care home
What are the 4 elements of the comprehensive geriatric assessment
- Physical assessment
- Psychological
- Social and environment
- Medication review
What tool may be used to perform a social and environmental assessment
Nottingham extended activities of daily living scale
What is used to grade the severity of pressure ulcers
Waterlow Score
What is grade-1 waterlow score
- Non-blanchable erythema of intact skin
- Discolouration of skin, warmth, oedema
what is grade 2 waterlow score
- Partial thickness skin loss (epidermis or dermis)
- Ulcer is superficial
- Presents as abrasion or blister
what is grade 3 waterlow score
- Full thickness skin loss
- Involves damage or necrosis to subcutaneous tissue that may extend to, but NOT through underlying fascia
what is grade 4 waterlow score
Extensive destruction, tissue necrosis, damage to muscle or bone.
