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frail care

Frail care is the care of elderly people who are described as frail as per following “Someone who is frail is not very strong or healthy. She lay in bed looking particularly frail. Synonyms: feeble, weak, puny, decrepit More Synonyms of frail. Something that is frail is easily broken or damaged.”

We hear about frailty in older adults. But what is frailty? What does it really mean? And how do we combat it?

Physical frailty was defined in a 2013 article by John Morley and company this way: “a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and physiologic function that increases an individual’s vulnerability for developing increased dependency and/or death.” (Morley JE, et al. J Am Med Dir Assoc 2013; Dr. Morley interview)

Sounds pretty ominous—and it is.  Frailty occurs as a result of many diseases and medical conditions. Evidence suggests that frailty may be related to lost muscle mass, (i.e., sarcopenia) that starts during midlife. Frailty means vulnerability, especially for those also facing acute illness, injury, or other stressor.  In people over age 65, about 10% have physical frailty, with women and those over age 80 even more likely to be frail.

Research has shown that frail individuals are high resource users—office visits, hospitalization, long term care.  They fall more often, need more assistance, have more complications related to surgery and chronic disease, and are more likely to die compared to similar people without frailty.

But frailty of manageable and often in a frail care facility. The Morley consensus paper suggests that everyone over age 70 and anyone with more than a >5% weight loss in the last year due to chronic illness be screened for frailty.  There is at least some evidence that exercise, calorie and protein support, vitamin D, and/or reduced polypharmacy have some efficacy in decreasing hospitalization, preventing frailty progression,  improving function, decreasing falls, or reducing disability. Some studies have even shown that these interventions have positive effects in nursing homes.