Living with frailty
For people living with mild frailty our focus should be upon helping individuals and their carers to acknowledge, understand and address the condition, ensuring they are aware of the support available to them. This can provide people with the tools they need to self-manage their condition and enable them to access appropriate support when they. This may be from families, carers, community and voluntary sector organisations as well as from health and care services. Supporting resources include:
- NHS England Practical guide to healthy ageing
- NHS England Practical guide to healthy caring
- National Fire Chiefs Council provides local contacts for GPs to make a referral for a Safe and Well visit from local Fire and Rescue Services
- NHS England case study on Social prescribing
- NICE guideline on Depression in adults: recognition and management
- NICE guideline on Falls in older people: assessing risk and prevention
- NICE quality standard on Falls in older people
- NICE guidance on Older people: independence and mental well being
- European Commission compilation of good practice on active and healthy ageing
- NHS England primer for general practice on dealing with mental health in older people
Living with moderate frailty
People living with moderate frailty will also benefit from ‘comprehensive geriatric assessment,’ in addition to the approaches described for mild frailty. Key elements include falls risk assessment, medicines optimisation and cognitive assessment, with consideration of modifiable psychosocial and environmental factors also being important. This works alongside the tailored approach to care recommended for people with multimorbidity.
By focusing on what it is important to each person and by understanding their sources of resilience and vulnerability, a person-centred and holistic care and support plan can be developed. This can help individuals to keep control over actions being taken to maintain their health and wellbeing, as well as reducing the risk of adverse outcomes associated with frailty.
- Public Health England falls and fractures consensus statement and resources pack
- NHS England pack for general practitioners on Dementia diagnosis and management
- NICE guideline on Depression in adults: recognition and management
- NICE guideline on Falls in older people: assessing risk and prevention
- NICE quality standard on Falls in older people
- NICE guidance on Older people: independence and mental well being
- British Geriatrics Society Comprehensive Geriatric Assessment
Living with severe frailty
Care for people living with severe frailty adds to the principles described for moderate frailty, with continued needs focused care review, assessment and care planning. It supports a continued focus upon personal goals and the available support required to achieve them.
This approach focuses on timely recognition of advancing frailty and thus enables appropriate steps to be taken to identify and meet an individual’s needs and wishes during the last stages of their life.
People living in care homes are likely to be living with higher levels of frailty and therefore merit particular attention to their care needs. Delivering comprehensive, consistent and structured enhanced support to them will ensure that their needs continue to be identified and met proactively.
- NHS England information about Enhanced health in care homes vanguards
- NHS England quick guide on Clinical input into care home
- NICE guideline on Depression in adults: recognition and management
- NICE guideline on Falls in older people: assessing risk and prevention
- NICE quality standard on Falls in older people
- NICE quality standard on Mental wellbeing of older people in care homes
- NICE guidance on Older people: independence and mental well being
- British Geriatrics Society Comprehensive Geriatric Assessment
Support for people living with frailty is one of the three particular challenges faced by the NHS (as noted in the first paragraph of the Five Year Forward View) and many organisations are already developing frailty services designed around the needs of patients.