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Frailty: why is it important and what does it mean for health & social care...
Wed 22 March 2017, 12:30 – 14:00 GMT
Dr. Martin Vernon. National Clinical Director for Older People & Person Centred Integrated Care at NHS England and Visiting Professor University of Chester will deliver a seminar entitled:
Frailty: why is it important and what does it mean for health & social care policy?
Frailty is the most problematic expression of human ageing we face today. It is relatively easy to identify when advanced but more difficult to spot in the early stages. It is characterised by the accumulation of health deficits over time which gradually increase the risk of needing health and social care support. The condition is more common in later life but not all older people are frail, and not all frail people are old. For people over 65, half of them will be classified as fit (that is, not frail) while 3% will be severely frail. In England there are just under 2 million people aged over 60, and just under a million people aged over 80 living with frailty.
Over 90% of these people will have problems with their mobility, over 60% need a walking aid and over 70% receive help from other people to live their lives. Typically someone who is frail will notice that they are slowing up, less able to do what they could before and need more help to accomplish day to day tasks including looking after themself. It is commonly associated with having several long term conditions at the same time, such as diabetes, heart, and lung or kidney disease.
Importantly, frailty is also a condition which significantly increases the risk of acute functional decompensation with prolonged and often incomplete recovery following relatively minor stressor events such as an acute infection or minor trauma. This can result in either death or requirement for more care and support than anticipated at the onset of the acute event. Most importantly frailty progresses over time and it can be used to predict the chances of requiring admission to hospital, a care home, developing disability or dying. People who have mild frailty are twice as likely each year (compared to someone of the same age who is fit) to require unplanned admission to hospital, admission to a care home or to die. For people with severe frailty these risks are over four times those for people who are fit at the same age.
Given that about 1 in 7 people over 60 in England are living with frailty in varying degrees, the routine identification of frailty in this large population of people across the country, while helpful, would be challenging. However there is now a validated way of finding groups of older people in the population who have varying degrees of frailty by using information already collected routinely about them and stored in their electronic GP health record. This allows us to identify groups of people who might be classified as fit, mildly, moderately or severely frail. This in turn can be used to better target health assessments and interventions to help people live with their frailty condition, reduce the risk of unplanned deterioration in their health and physical condition and to help keep fit older people, fit for as long as we can.
Taking this approach to managing the needs of an ageing population also poses some new challenges when placed in the context of a publically funded, resource constrained health and care system. How do we activate fit older people to keep them fit? How do we best help people plan for advancing frailty? Does the traditional biomedical model of healthcare need to now give way to a biosocial model which places greater emphasis on care, not cure? What are the implications of frailty care for public health policy?
Professor Vernon seeks to address these pressing societal ageing questions in his seminar.
This event is free.
Date and Time
Faculty of Health and Social Care
University of Chester
Room CRV119, Riverside Campus, Castle Drive