Mild Frailty
CFS SCORE: 5
KEY INTERVENTION: Community Connectivity
| Involve
Enhance the voice of older people, carers and families to tackle the frailty challenge together at a community and individual level.
Visit the Frailty icare website for more on ‘Involve’
| Consider
Always think frailty! An awareness of the modifiable risk factors for frailty and complications related to frailty can help with early appropriate lifestyle interventions.
Chronic Pain
Frail people are 2.5 times more likely to have headaches, musculoskeletal pain compared to non-frail people. Two thirds of frail people experience frequent or ongoing pain and 80% indicate it interfered moderately with daily living activities.
Mobility
Frail people are 11 times more likely to have mobility limitation, balance and walking problems compared to non-frail people and are nearly 9 times more likely to use a walking aid.
Falls
Frail people are nearly 3 times more likely to have had one fall or 4 more likely to have had two falls in the last year compared to non-frail people.
Loneliness
1.4 million people suffering from loneliness. Loneliness is linked with higher risk of frailty, mortality (equivalent to smoking 15 cig /day) and care home admission.
Frail older adults have a smaller network size and higher levels of loneliness. There social vulnerability of physical frail older adults should always be taken into account in planning care provision
Depression
Frail people are over 5 times more likely to say they feel lonely, 4 times more likely to feel depressed or sad much of the time and over 5 times more likely to feel dissatisfied with life.
Social Isolation
Frail people are over 5 times more likely to say they feel lonely or socially isolated, 4 times more likely to feel depressed or sad much of the time and over 5 times more likely to feel dissatisfied with life. BMC family practice. David R. Lee
Visit the Frailty icare website for more on ‘Consider’
| Assess
If there are any signs of pre-frailty or frailty, patients should be assessed using the Clinical Frailty Scale for verification and classification of their level of frailty.
Visit the Frailty icare website for more on ‘Assess’
| Respond
Community connectivity with access to and involvement of the Voluntary, Community and Social Enterprise sector.
What works?
Specific tailored support for long-term conditions, optimising pain, immobility and falls (see previous Pre-Frail section).
Adopt shared decision making to enable choice and engagement to build learning and relationships.
Focus on and invest in recognised ways of working that embrace ‘relationship and asset-based approaches’ and ‘everyone doing their bit’ to improve the health and wellbeing.
Enable healthcare professionals to refer patients to non-clinical pathways that are co-designed to improve their health and wellbeing.
Encouraging community connectivity with access to and involvement of the Voluntary, Community and Social Enterprise sector to prevent social isolation and loneliness.
Visit the Frailty icare website for more on ‘Respond’
| Evaluate
To see if you are making a difference, whether at an individual level or within your local area or system, consider the following…
The benefit for individuals
Measuring what you’re doing
The impact on populations, communities and services
Benefits
Improves the experience of care, health and wellbeing and prevents mental health
Reduces crises that lead to unplanned hospital or institutional care admissions.
Reduces unnecessary GP/primary care appointments
Benefits fitness, activities of daily living and quality of life
Improves physical function and muscle strength
Reduces the rate and risk of falling
Delays the progression to frailty
Impact
Within the NENC, mildly frail people are 2.6 times more likely to have fallen in the last 12 months than fit people aged over 65, moderately frail people 3.8 times more likely and severely frail 6.3 times more likely.
Loneliness and impact
Relationships and quality of life
Musculoskeletal problems
Visit the Frailty icare website for more on ‘Evaluate’
Making Sense of Social Prescribing (University of Westminster)
All the Lonely People: Lonely in Later Life (Age UK)
Community-centered Public Health: Taking a whole system approach (Public Health England)
Preventing falls in older people overview (NICE)
For more useful resources, visit the ‘Respond - Community Connectivity’ and ‘Respond - Specific Tailored Support for Long-Term Conditions’ sections of the Frailty iCARE website.
