Inspirational lessons in frailty

Frailty in older patients is an important issue that we all need to be aware of in light of our ageing population

Life expectancy is on the up and our population is ageing, so it made sense to me to learn more about nursing older people.

With this in mind, I’ve embarked on an older people’s fellowship at King’s College London (KCL), which has been really inspiring.

The work we’ve done has really highlighted the importance of building a robust evidence base to influence clinical practice to provide intelligent, compassionate care and treatment to their older patients.

In particular on the course, I’ve gained valuable insight into frailty - a clinically recognised state of increased vulnerability among older adults.

According to the British Geriatrics Society, frailty is associated with a decline in an individual’s physical and psychological reserves.

While frailty has many definitions, one that was shared with us was a definition by Rockwood et al (2005), which defines frailty as a multidimensional loss of reserves (energy, physical ability, cognition and health).

Seen as a long term condition, the Department of Health, defined it as ‘one that cannot currently be cured but can be controlled with the use of medication and/or other therapies’.

Being part of the fellowship has helped me consider my approach to discussing the concept of frailty with patients, families and their carers.

The KCL lectures have also emphasised the importance of being aware of frailty indicators, to alert us to define underlying frailty, whatever the problem the patient presents with.

Most holistic nursing assessments will pick up on these indicators, which include:

  • Signs of deficits in motor processing
  • Cognitive decline
  • Weight loss
  • Reduced mobility
  • Muscle weakness/lack of strength
  • Poor balance
  • Lack of endurance/reduced stamina
  • Limitation of physical activity

These indicators should raise suspicions of underlying frailty and need to be investigated further.

Overall, the fellowship journey has made me reflect on my current practice and helped me focus on the importance of implementing evidence-based clinical practice to improve outcomes.

About the author

Beverley MarriottBeverley Marriott is a community matron at Birmingham Community Healthcare Trust

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