The Edmonton Frail Scale can help discover frailty at an early stage, and address individual concerns. Once a person knows that they are living with frailty, they can respond in ways that make them more resilient, make better health care decisions, and focus on the areas that need the most attention.
The following discussion points between an individual, their family, and their health care professionals are worthwhile at all stages.
Responding to Frailty
Make a Personalized Care & Support Plan
Because frailty introduces more uncertainty in health and independence, individuals who live with frailty may find themselves in transition between home, hospitals, and other care or support services. It is never too soon to have a frank discussion regarding goals and expectations if different situations arise. It helps when those wishes are written down in a personalized care and support plan.
Make Nutrition a Priority
Frailty is usually associated with weight loss rather than gain. The onset of frailty should motivate a deliberate plan to prevent weight loss through adequate intake of calories, vitamins, and minerals.
Keep Moving
We know that physical activity will reduce or postpone frailty. The favorable effects of exercise may be enhanced in programs that are group-based and “multi-domain”. A multi-domain exercise program may also include other things such as nutrition, cognitive training and socialization.
Strengthen Social Networks
A major aspect of resilience is in the family, friends, neighborhoods, communities, and care-giving networks that help a person to perform at their best. When frailty is identified, efforts should be made to avoid social isolation.
When Making Decisions
Ensure that proposed medical treatments are right for you
Typically, medical guidelines don’t take frailty into account. Be sure to have a conversation with health care professionals and family members to decide how to apply these guidelines to yourself. Some medications or procedures may not have the same benefits and may introduce unwanted risks.
Access processes of care that minimize harm
Harm reduction strategies will have the greatest benefits for those who are most vulnerable. Some community care environments and hospitals offer services and settings that are tailored to the needs of individuals who live with frailty. For example, this might mean closer attention to certain medications and health conditions at the time of surgery.
Consider lower risk alternatives for procedures
Frailty is a very important consideration when higher stakes decisions are before you. The best decision may be to decline a procedure altogether, or go with an option that involves less risk.
Involve individuals and teams that specialize in the care of older adults
Care providers should consider when to involve a specialist in Geriatric Medicine, other specialists in the care of older adults, or a team that offers Comprehensive Geriatric Assessment (CGA). These care specialists have more to offer when there are geriatric syndromes, upcoming high risk procedures, diagnostic uncertainty, and challenging symptom control.
Focusing on the Problem Areas
The Edmonton Frail Scale is a multidimensional frailty measure. This means that it helps draw attention to the problem areas. Let’s say that the overall EFS score showed mild frailty, and a closer examination revealed that the problem areas were medications, nutrition, and mobility.
A primary care team could then get to work by conducting a structured medication review to optimize the medications, and make referrals to a dietician and a physiotherapist for additional recommendations.
