ICF/Frailty and CGA |X Flashcards
What is the International Classification of Function?
It is like the International Classification of Disease (ICD) used to classify diseases and mortality, but concentrates on health and combines psychosocial as well as biological theory
a. Body function and structure
b. Activities (limitation)
- Environmental factors
- Personal factors
c. Participation (restriction)
What is the ICF used for?
- Assessing individuals
- Allowing comparisons across countries and cultures
- It can also be used to inform public policy
- As a research tool.
What does activities (limitation) refer to?
Refers to things like walking cooking a meal, having a convo etc.
If an activity cannot be undertaken then the phase “activity limitation” is used. Sometimes the word disability is used
What does participation (restriction) refer to?
Participation refers to participating in society, living life in the way the person wants, in the way that they expect and is expected of them. It involves roles.
When participation is reduced or lost, the phrase “participation restriction” is used. Sometimes the word “handicap” is used.
What does environmental factors refer to?
This could refer to the physical environment or the social environment.
Environmental factors interact with impairments to influence performance of activities and participation e.g. an artificial leg is an environmental factor that influences mobility
What does personal context refer to?
Some people take risks, others don’t: this affects the desirability and suitability of approaches to their management.
Others may want to do tasks “normally” and so would prefer to walk rather than use a wheelchair.
Others however, may welcome assistance if it gets the task achieved, or gets it done quickly or safely.
Some people highly value lack of dependency in performing tasks, and would prefer to struggle and do things themselves.
What do you need to know in the Sx to know about frailty?
- Who they live with
- What type of accommodation they live in
- Any carers/help
- Continence
- how often do you go at day/night
- ever find you don’t empty bladder fully
- do you find when you need to go, you need to go - Mobility - stair lift/walking stick etc
- Washing/dressing/cooking
- Previous falls
- Visual/hearing impairment?
What is the definition of frailty?
A medical syndrome with multiple causes and contributors that is characterised by diminished strength, endurance, and reduced physiological function that increases an individual’s vulnerability for developing increased dependency and/or death
What does frailty mean practicality wise?
Increased vulnerability to ‘minor’ stressors
- When they get ill, they can take a big dip and go from being independent to dependent
- They also never recover to baseline after the incident
What are 3 ways you can measure frailty?
- Gait speed - >5s to walk 4m means frail
- The Timed up and go test
- Sit in chair, walk 3 m and turn back and sit down. >10s means frail - PRISMA-7 questionnaire
- Clinical frailty scale
- take a history
What are frailty syndromes?
xxxxxx
- Incontinence
- Falls
- Mobility
- Polypharmacy + side effects
- Delirium
What is the CGA?
Gold standard for managing frailty
A multi-dimensional, interdisciplinary diagnostic process to determine the medical, psychological, and functional capabilities of a frail older person in order to develop a coordinated and integrated plan for treatment and long-term follow-up
Form:
Problems list
Management plan
What are the 5 domains of the CGA?
- Physical
- Psychology
- Functional
- Social
- Environment
What are the 4 things that are in the process of the CGA?
Assessment -> Stratified problem list -> Bespoke management plan -> Goals
(And back into assessment in a circle)
What is the relationship between frailty vs disability vs comorbidity?
They are all different but all cross over with each other
