HealthInfo Waitaha Canterbury

Frailty in older people

Adults with frailty may not be as strong or as healthy as they used to be. Everyday activities might be harder for them. They are likely to find it harder to bounce back and recover from events like illnesses, injuries and surgery than in previous years.

Frailty is more common in older adults. But being older does not necessarily mean you will be frail.

It is important to know if you have frailty. If you have frailty, something that seems straightforward can cause a substantial change to your health. You may not have the same ability to bounce back and recover as you used to. Knowing this can help you and your whānau (family) prepare for a change in your health. It can also help you to prioritise actions that increase your body's resilience and prevent frailty or stop you becoming frailer.

Older people with frailty have a higher risk of:

• falls
• immobility
• incontinence
• confusion
• being admitted to hospital and needing long hospital stays
• needing nursing care.

Causes and risk factors of frailty

Common risk factors of frailty include:

• falls
• being older
• being female
• chronic health conditions such as COPD, multiple sclerosis, chronic fatigue syndrome, chronic pain, diabetes, stroke, heart disease, dementia and depression
• oral health problems such as loose dentures, dry mouth, toothache and broken teeth
• poverty
• being socially isolated
• hearing and vision problems
• lifestyle factors such as low levels of exercise, smoking, drinking alcohol and not eating well
• being an unhealthy weight
• taking a lot of medications.

Diagnosing frailty

Your doctor will diagnose frailty by considering many factors. These include your health conditions and physical fitness. They will consider:

• your walking speed and level of physical activity
• your grip strength
• your energy levels
• whether you need help with daily activities such as household chores, personal care, taking medications and handling money
• your weight and body mass index (BMI) and how well you eat.

There are several scores and questionnaires used to help health professionals diagnose frailty. An example of these is the Rockwood Clinical Frailty Scale.

Self-care for frailty

There are ways you can help prevent frailty or stop it getting worse. The most important ways are:

• Doing exercises to improve muscle strength and balance two to three days a week. See Live Stronger for Longer for free videos and resources to help you exercise at home. Live Stronger for Longer can also help you find community strength and balance classes. Also, see the link below to a video of a 10-minute exercise routine you can do at home.

  Moving daily in as many ways as possible will also help. Even walking for 10 minutes a day can make a difference.

• Eating well, especially getting enough protein. Aim to have a protein-rich food at every meal and snack. If you are losing weight or struggling to eat well, your doctor may prescribe oral nutritional supplements or refer you to a dietitian.

Other ways to help prevent frailty or stop it getting worse include:

• Limiting alcohol.
• Stopping smoking.
• Getting enough sleep.
• Staying connected with family and friends.
• Keeping your brain active.
• Wearing hearing aids and glasses if prescribed.

It can be hard to make changes and create good habits. Consider using the LifeCurve online tool or app. It provides a personalised package with movement routines and hints and tips on how to age well, stay active and be safe.

Consider sharing your frailty diagnosis with friends and whānau so they can help support you to make changes.

Getting help with frailty

Recognising frailty early is important. Your healthcare providers will take into account your frailty when they make health care recommendations to you.

Some of the things your healthcare providers may do to help reduce the impact of frailty include:

• reviewing your medicines regularly and removing unnecessary medicines to avoid any potential harm
• conducting regular health checks, including your physical and mental health
• assessing and providing home care and community support such as meals on wheels, help with household chores and showering or bathing
• reviewing your home circumstances to reduce risk factors that can cause falls
• discussing advanced care plans with you
• supporting healthy lifestyle choices.

  HealthInfo recommends the following videos

• Hamilton Health Sciences – Seniors and protein

  Ideas for getting more protein into your meals and snacks.

• Stronger for Longer – Strength & balance 10-minute home routine

  A fun 10-minute exercise routine you can do at home. It includes alternatives for different energy levels.

  HealthInfo recommends the following pages

• Carers New Zealand

  Information, advice, learning and support for families with health and disability needs. Phone 0800-777-797 or email them. They have links to organisations that offer local support to carers and their families.

• Eldernet – Home help & personal care

  Information about services that may be available to help support you to remain independent in your own home.

• Physiotherapy New Zealand – Strength and balance exercises

  Seven simple exercises will help you keep your strength and balance and reduce your risk of falls.

  HealthInfo recommends the following apps

• Healthify He Puna Wairoa – LifeCurve app

  Information about the LifeCurve app to support healthy aging.

Written by HealthInfo clinical advisers. Page created April 2024.

Sources

Page reference: 1339914

Review key: HIFOP-1339914