Using a population screening tool to identify people with frailty in the community: the e-frailty index

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by Laura Dobie, Knowledge and Information Skills Specialist

The Challenge

A person with frailty can experience serious adverse outcomes following even a relatively minor illness. Timely identification of frailty can help to reduce the likelihood of a poor outcome following an intervention (or eliminate the need for an intervention entirely) and support the long-term management of people’s health needs.

If we can identify people with frailty in the community, we can offer preventative support that could improve their quality of life and reduce the risk of unscheduled admissions.

There are a number of tools which professionals can use to screen people for frailty (see the British Geriatric Society’s Fit for Frailty guidance). However, many of these tools are based on questionnaires that require practitioners to have direct contact with individuals and can only be used to assess people who are actively engaged with services.  It would be resource-intensive and challenging for services to screen large population groups for frailty using these individual assessments.

The risk stratification tool, Scottish Patients at Risk of Re-admissions or Admissions (SPARRA) identifies individuals within the whole population at risk of hospital admission based on nationally-collected data on acute admissions and community prescribing.  However, it does not discriminate frailty from other high-risk population groups and can only identify individuals who are known to services, as they have had recent acute admissions or have been prescribed high-risk medications.  Alternative population screening tools are needed to identify people with frailty living in the community. Continue reading “Using a population screening tool to identify people with frailty in the community: the e-frailty index”

Scottish Ambulance Service Falls and Frailty Pathways Action Group first meeting

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On 25th November 2016 the Living Well in Communities team from Healthcare Improvement Scotland’s Improvement Hub (ihub) supported the first meeting of the Active and Independent Living Improvement Programme (AILIP) and Scottish Ambulance Service Falls and Frailty Action Group. This Storify summarises the discussions from the day. Presentations and other resources can be accessed on the Falls and Bone Health Community site.

 

Preventing falls in Argyll and Bute: Cowal Befrienders’ exercise classes

Strength and Balance

In this article we look at a service which is aiming to prevent falls by supporting older people who have difficulty attending classes to take part in exercise.

Background

Exercise has an important role to play in reducing the risk of falls among older people in the community. A recent BMJ review has indicated that exercise-based and tailored interventions are the most effective way to reduce falls and associated healthcare costs among older people in the community, while a recently updated Care Inspectorate good practice resource, Managing Falls and Fractures in Care Homes for Older People has stressed the importance of keeping mobile, doing regular exercise and being physically active.

The Cowal Befrienders’ falls prevention exercise classes are working towards the overall aim that “Older people have a reduced risk of falls that may affect their ability to live independently in the community”.

The classes

Cowal Befrienders host two strength and balance exercise classes per week for older people who require some help to get to the Befrienders’ drop-in centre where the classes are held and support to participate in exercise classes.

Classes are co-ordinated and delivered by Otago-qualified staff employed by Cowal Befrienders (the Otago  exercise programme is designed to prevent falls). Referrals and assessments are managed by the NHS Highland physiotherapy team.

Clients are entitled to six free classes, and can continue to attend for a modest fee of £2.50 per session. There is a small charge for clients requesting transport to their classes to help offset the additional costs incurred to provide this service (£3 return for individuals living within Dunoon, and £5 return for those living outside of the town).

In addition to health and wellbeing benefits, such as increased strength, balance and mobility, and helping participants to feel more confident and independent, the classes also have a social aim: to help older people to expand their social networks and foster peer support, and to increase access to health-promoting information that meets their needs.

The social aspect of the classes has been particularly valued by participants, with 97% citing this as one of the things that they enjoyed most about the classes. Clients also particularly appreciated the encouragement that they were given by staff and volunteers, and the pace of the classes. Continue reading “Preventing falls in Argyll and Bute: Cowal Befrienders’ exercise classes”

Living Well With Frailty: Conference Outputs

The Living well with Frailty event, held at Heriot-Watt University in Edinburgh on the 27th of October brought together colleagues from across the health and social care sector to undertake a deep dive into the issues surrounding frailty.

The day comprised morning and afternoon plenaries, as well as eight breakout sessions ranging from ‘A focus on Dementia – personal outcomes in practice?’ to ‘Care Homes: My care, Your care, Our care – Designing a Care Home for the future’. For a full list of the sessions please download a copy of the agenda from the day. A comprehensive overview of each of the sessions is available below.

Breakout sessions
Timely identification and co-ordination of care for older people living with frailty
Presenters: Penny Bond and Karen Goudie

During this workshop, Karen and Penny from Healthcare Improvement Scotland led a discussion with attendees on what it means to be an older person with frailty going through our hospital system. Brief patient stories were shared to highlight opportunities and challenges as a starting point for discussion. Attendees then shared experience of testing and implementing different approaches to identifying and coordinating frailty care within acute care settings. The timely identification and co-ordination of care for older people living with frailty presentation can be viewed via the following link and you can watch a video of Mrs Andrews’ story on YouTube below.

Continue reading “Living Well With Frailty: Conference Outputs”