Frailty

Question 1

What is frailty?

Answer 1

A long term health condition characterised by a loss of physical emotional and cognitive resilience as a result of the accumulation of multiple health deficits.

increased vulnerability to poor resolution of homesotasis after stressor event whcih increases the risk of adverse outcomes (falls, delerium and disability)

Question 2

scoring systems for frailty

Answer 2

electronic frailty index (eFI)

clinical frailty scale (CFS) (1-9)

PRISMA7 score (>3)

Gait speed test

• resident care homes
• living with dementia
• > 65 y/o who have experienced one of the major frailty syndromes (Falls, immobility, delirium, incontinence, susceptibility to side effects of medications)

Question 3

PRISMA7 questions

Answer 3

Appendix three: PRISMA7 questions
A score of three or more indicates frailty.
1. Are you more than 85 years?
2. Male?
3. In general do you have any health problems that require you to limit your activities?
4. Do you need someone to help you on a regular basis?
5. In general do you have any health problems that require you to stay at home?
6. In case of need can you count on someone close to you?
7. Do you regularly use a stick, walker or wheelchair to get about?

Question 4

STOP START medication review tool

Answer 4

https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf

Question 5

discharge plan

Answer 5

• discharge plan begins before or on admission
• clear detailed info of baseline
  family/care home, notes from previous admission
• comprehensive geriatric assessment
• MDT
• PCC

coordinated
- clear allocation of actions, timescales

Question 6

pathways (DTA)

Answer 6

DTA 1:
reablement
care package
home first

DTA 2:
community hospital
temporary care home
rehab unit
intermediate care bed

DTA 3:
care home (with nursing)
hospice