Pre-Frail

CFS SCORE: 4

KEY INTERVENTION: Tailored support for long-term conditions

| 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 understanding signs of pre-frailty can help with early appropriate lifestyle interventions.

Deafness, Hearing and Oral Health
- Frail people are four times more likely to have vision problems affecting ADLs, 2.5 times more likely to have hearing problems and over 5 times more likely to have poor oral health affecting eating and speech.
Emotional and Mental Health
- Frail people are nearly six times more likely than non-frail people to say they have emotional or mental health problems moderately interfering with their daily activities. For example, 80.1% versus 18.8% respectively.
Polypharmacy
- People have nearly 2 times the odds of frailty with polypharmacy (5 or more medicines) and nearly 5 times the odds of frailty with excessive polypharmacy (10 or more medicines) respectively.
Chronic Diseases
- Frail people are over five times more likely than non-frail people to say they have three or more chronic diseases. For example, 55.9% versus 10.1% respectively.

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

Specific, tailored support for Long Term Conditions, including supportive self-management and shared decision-making to develop a self-management plan (with contingency planning) optimising falls and immobility, medicine/polypharmacy and mental health.

What works?
- Involve everyone in co-ordinating support.
- Offer education tailored to need and literacy.
- Consider TECS to self-manage long-term condition(s).
- Consider personal care budgets and direct payments.
- Screen and advise about falls, encouraging strength and balance training.
- Tackle polypharmacy with specialist pharmacists.
- Identify and manage depression and anxiety, linking to community services and VCSE.

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
- SSM improves a person’s knowledge about their conditions, coping ability and use of health care
- Streamlined management of LTCs
- Fewer unnecessary GP appointments
- Fewer medicines prescribed, adverse drug reactions and hospitalisation (adverse reactions)
- Improve medication use (when staff trained in SMR receive training)
- Reduce the risk of falls
Impact
- Medication reduction/costs
- Reduced GP appointments
- Mental health reduction