Lecture 9- Frailty Flashcards
frailty
- ageing related phsyiological changes across mutliple body systems
- loss of physiological reserve
- increased vulnerability to a wide range of stressors
Physiological definition
Clinically recognizable state of increased vulnerability resulting from aging- associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is comprised.
Phenotypic definitions
Low grip strength, low energy, slowed waking speed, low physical activity, and/or unintentional weight loss.
what can be used to quanitfy a persons frailty
clinical frailty scale
geriatric giants
the principal chronic disabilities of old age that impact on the physical, mental and social domains of older adults.
name some geriatric giants
- Immobility
- Instability (Falls)
- Incontinence
- Impaired memory (Dementia, Delirium)
- Iatrogenesis (Caused by us!)
often frail older people with have..
non-specific presentations
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‘Non-specific’ presentations
- Frail older people will often not have the ‘classic’ symptoms of common illnesses.
Frailty and outcomes
remeber that older people are vulnerable to
IATROGENIC harm
e.g. anticholinergic burden from antipsychotics and alzheimers medication etc
anticholinergic burden side effects
dry mouth, dry eyes, constipation, urinary retention, blurred vision and increased heart rate, while central effects range from dizziness, sedation, confusion and delirium
what cna be used to quanitify antichonlinergic burden in polypharmacy pts
aging brain care tables
how are medical decisions made
Person centred decision-making most important but involves…
- Disease-centred decision making
- E.g. which medication should be given
- Professional- centred decisions
- limited by lack of time, skills, concerns about risk
Need to strike the right balance
ReSPECT form
ReSPECT is a national patient held document, completed following an Advance Care Planning conversation between a patient and a healthcare professional.
The ReSPECT process creates personalised recommendations for a person’s clinical care and treatment in a future emergency in which they are unable to make or express choices.
These recommendations are created through conversations between a person, their families, and their health and care professionals to understand what matters to them and what is realistic in terms of their care and treatment.
what can be used to generate a care plant
comprehensive geriatric assessment
