The Frailty Approach: Rest-of-Life Care of the Older Person

Abstract

This chapter aims to provide the nurse, therapist and social care professional with confidence to quickly and effectively assess a newly encountered frail elderly patient in all settings. This is done by using a Frailty Approach, a recent and necessary paradigm for care of our ageing population. The key areas of Frailty, Dementia, Delirium, Polypharmacy, Co-morbidities and Falls are described.

Thereafter, the main tool for this approach is explained in detail—Comprehensive Geriatric Assessment (CGA), which requires the input of a multidisciplinary team (MDT) to be effective. With its four domains—Medical, Social, Functional and Cognitive, CGA details a logical, timely and effective way of gaining the essentials of the patient’s presentation. A guide to summarising and recording this is given to enable appropriate care-planning and management tailored to the patient’s needs.

This is underpinned by a detailed case scenario, where we meet 92-year-old Violet. Violet’s fall and presentation to the emergency department illustrates the use of CGA to establish an accurate picture of her needs and how to go about effectively addressing them.

The chapter then describes suggestions for further learning in this broad and developing subject area, which is increasingly the focus for most health services across the world.