frailty explained

There was a significant decline in physical fitness, followed by a bout of influenza 2 months before our first meeting. Many people with multiple long term conditions (so called multi-morbidity) will also have frailty which may be masked when the focus is on other disease based long term conditions. He could not afford a physiotherapist at home either. after a fracture or any infection in vital organs). Anuj even ended up giving two more paracetamols to her that night to relieve her temperature and in the fear that his mother might not survive the night. She was in the hospital for over a month because of the waxing and waning course of the disease. There are other crucial factors like improper dentures, medical morbidity like depression, financial problems, social inhibitions, drugs and, commonly decrease in gastrointestinal motility. All Rights Reserved, Advice on caring for someone in another household, Advice on caring for someone you live with, Benefits and accessing cash - coronavirus advice, Housing rights advice during coronavirus pandemic, Shielding, social distancing and self-isolation. Once she got down from her bed, she felt giddy and lost control and fell. He explained that not only did he respond very well to the treatment but, most importantly, the detailed explanation about this condition helped him understand his decaying body better. Generally individuals with three or more of the characteristics are said to have frailty (although this model also allows for the possibility of fewer characteristics being present and thus pre-frailty is possible). Frailty varies in severity (individuals should not be labelled as being frail or not frail but simply that they have frailty). But, there is no universal rule to prevent frailty. Frailty and cognitive impairment—A review of the evidence and causal mechanisms. He took medicines as prescribed by his doctor and recovered from the symptoms, but his weakness persisted. It uses computer based tools, for example Advanced Clinical Groupings (ACG), Prediction of individuals At Risk of Readmission (PARR) or Scottish Prevention of Admission and Readmission (SPARRA). This is a common scenario for the frail elderly and elderly persons with multimorbidity when they have acute deconditioning; they take longer time to recover. This could mean anything from a simple episode of ‘flu to a major intervention like a joint replacement. Both these questions cannot be answered easily. This resource explores the challenges around language and perceptions of frailty amongst older people, carers and healthcare professionals. Several centuries after Shakespeare, in 2001, Dr. Linda Fried from the John Hopkins Institute tried to enlist “frailty” in the medical literature to explain the sudden decline in physical fitness of the elderly. Additionally, these tools, which were not designed to look for frailty, often highlight individuals who have high cost conditions not amenable to modification (such as immunosuppression after organ transplant). It improves the inflammatory state, mood and cognition. Our service is flexible to suit the different needs of everyone who takes part. How to recognise frailty in a routine situation, emergency situation, or in an outpatient surgical setting, including a range of established tests you can use. There are two broad models of frailty. Usually, aspirated material is cleared by mucociliary action and alveolar macrophages. He requested me to not put him through the same aggressive regime of exercise and nutritional module, stating that he would try to exercise on his own. Factors like gender, malnutrition and financial instability and, most importantly, mobility restriction further worsened frailty in her case. Studies had suggested that NW helps in improving mood and cognition in the long run [24]. Prevalence and predisposing factors of frailty syndrome in elderly (> 75 years) Indian population in Sub acute care setup. Impact of frailty and functional status on outcomes in elderly patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: rationale and design of the IFFANIAM study. Over 10 million scientific documents at your fingertips. The frailty phenotype gained popularity among specialists in clinical practice as a method to identify vulnerable individuals undergoing medical or surgical interventions. This is followed by early to late stages and then severe frailty, which results in a rapid downhill course that makes an individual completely dependent on others to perform their daily activities (Fig. Her temperature was continuously fluctuating between 102 and 105 degrees. This figure rises to between 25% and a 50% for those aged over 85. Due to lack of space, it was difficult to move Mrs. Bajaj on the wheelchair. This was a state of increased risk compared to others of the same age. I continuously kept on putting cold-water cloth straps on her forehead to bring the temperature down”. Effort has also been made to deconstruct the continuum of frailty showing how from robust independence an individual slowly and steadily becomes severely frail and completely dependent. “I understand that death is natural and inevitable process of life. Suddenly, one of the days when I was doing my rounds at the High Definition Unit of our department, I saw Mrs. Bajaj admitted with aspiration pneumonia, a very common complication for the frail elderly. Older people may not recognise themselves as living with frailty and there is evidence that older people do not want to be considered as ‘frail,’ although happy to accept that they are an older person. Frailty is generally characterised by issues like reduced muscle strength and fatigue. After his retirement in 1988, he kept himself busy by providing consultancy services to various private firms. Frailty is a 2001 American psychological horror film directed by and starring Bill Paxton, and co-starring Matthew McConaughey and Powers Boothe.It marks Paxton's directorial debut.The plot focuses on the strange relationship between two young boys and their fanatically religious father, who believes that he has been commanded by God to kill demons disguised as people. Even apparently simple interventions like a move to a short term residential placement for respite, a trip to the local emergency department after a fall or the trial of a new analgesic can have unforeseen and adverse outcomes. These thoughts resonate in the minds of several octogenarians (80–89 years) suffering from frailty. Anorexia of aging: Risk factors, consequences, and potential treatments. However, according to Mr. Tripathy, his sense of smell and taste had drastically decreased; he could not differentiate between different foods and eating the same home-delivered food that he had been having for the past few years. Not affiliated This includes (but is not limited to) the following: It is self-evident that the type of assessment will differ when dealing with an individual who is currently unwell (and therefore a short screening assessment may be of limited benefit) instead of being in a stable situation. Walker, N. F., Meintjes, G., & Wilkinson, R. J. To save up for one’s last phase of life will not only help in physical independence but will help to maintain financial autonomy. Thakur, J. The family had accommodated themselves within two small rooms. What is successful ageing and who should define it? Routine outpatient appointments in all departments, including surgical (orthopaedic, GI, vascular and ophthalmic departments), medical and mental health (memory clinics). She stopped all movement including visiting AIIMS for physiotherapy. However the inter-relationship between prescribed medication and frailty independent of co-morbidity is a relatively under-exploited area. Fortunately, she suffered no injuries to her head or any fractured bones. Doctor, please save her”. (2001). I am weak, shaky and slow. Mr. Tripathy’s perceived control, i.e. What is the secret of active ageing? I know I should eat a proper diet and do exercise, but I do not feel motivated to do anything except to just escape this life. Anuj was compelled to use all the money that he had saved up for his children’s education. With the intake of TB medicines, she was doing well and had even gained some weight. Her recovery, however, took a long time. A central feature of physical frailty, as defined by the phenotype model is loss of skeletal muscle function (sarcopenia) and there is a growing body of evidence documenting the major causes of this process. Mr. Tripathy was called in to learn his exercise and nutritional module after 6 weeks and was examined after 3 months. Please let me die peacefully. So, lifestyle with a healthy diet and regular exercise is probably the best way to compress the morbidity [, Mr. Tripathy never indulged in unhealthy practices like consumption of tobacco, alcohol or rich diets or so-called fast food. Most of the elderly inevitably suffer from frailty, which leads to progressive deterioration of the overall functionality. Similarly, there is overlap between frailty and physical disability – many people with frailty also have disability, but lots of people with a long term disability do not have frailty. Khandelwal, D. (2012). Burden of frailty in the elderly population: Perspectives for a public health challenge. A current approach seeks to break down a practice population according to risk of using future health care resources including hospital admission. Reports revealed that he had no major disease like TB or cancer; however, he was worried about losing weight. Frailty may be the cause of disability in some patients and the consequence in others. Few difficult questions, such as how to find out frailty in its early stage in day-to-day practice, the impact of frailty on the individual, family and society, how to prevent it through optimistic life course approach and evidence best intervention of frailty status, have been answered. He felt that recently he had become weaker and no longer possessed the calibre to be part of long-distance runs. Unfortunately there is no evidence that focussing resources on these individuals improves outcomes. People living with frailty are more likely to experience public and private services that are not geared to their needs. However, extrinsic aspirations include wealth, fame and image, which were not relevant for him. During our discussion, I came to know that he had a decreased appetite but no apparent weight loss. From emergency department she was shifted to the Neurology Department. I looked at the referral details from the Neurology Department of AIIMS. They have achieved a response rate of over 85 per cent and those who respond are then visited at home by an elder care facilitator before undergoing a comprehensive geriatric assessment at the surgery by a GP. This would require establishing a multidisciplinary and skilled manpower base for old age healthcare at the primary care establishments. There is evidence that shows cognitive and physical frailty to be a common pathophysiologic mechanism with risk factors such as low walking speed, alleviated inflammatory cytokines (IL 6, IL 8, CRP) and low brain-derived natriuretic factor (BDNF).

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