Screening and Assessment

Screening for frailty can result in early detection which can help you make changes, plan or put support in place that can:

  • Improve outcomes of individuals
  • Support an individual to live well at home
  • Avoid unnecessary harm
  • Potentially reverse the severity of frailty

Screening Tools

Reported Edmonton Frailty Scale – designed to identify frailty in clinical settings and can be completed in a very short amount of time. It focuses on nine domains – two are performance based for functional performance and cognitive impairment and the others focus on general health, functional independence, social support, medication, nutrition, mood and continence.

Each question is scored from 0-2. These are totalled up and a score is given, a higher score indicates a higher degree of frailty. The scores are split into 5 categories: Not Frail, Vulnerable, Mild Frailty, Moderate Frailty and Severe Frailty.

Rockwood Frailty Scale – is a measure of frailty based on clinical judgement, designed to grade the degree of frailty following a comprehensive assessment. The scale has nine points from 1: Very Fit to 9: Terminally ill.

Assessment and Intervention Tools

iHub Frailty and Falls assessment and intervention tool – this tool can be used to support assessment of frailty and help to identify interventions that will suit the needs of the individual and signpost to right care and support within the community.

The tool guides the user through ten topics to consider when assessing Frailty and which interventions could be considered. The ten topics covered are: Frailty/falls, social circumstances, mental health, environment, nutrition, dizziness/blackouts, medications, mobility/balance, continence and vision/hearing. This is summarised in the following poster – iHub Frailty and Falls assessment and intervention tool – At a glance poster.

Eyesight and Hearing Eyesight and hearing loss can also be factors in a fall.

Eyesight

Your eyesight helps you to move around safely and be steady on your feet. As you get older your vision can change. You may notice blurred vision, less accuracy when judging depth or distances, not being able to see as well in low contrast situations, it is taking you longer to adjust to changes in lighting or a reduction in what your eye can see when looking forward. Changes in your vision can increase the risk of falls.

Look after your eyesight

Have regular eye checks (every two years until you are 60 then every year following). If you wear glasses or contact lenses look after them and have your prescription checked regularly.

For more information on eye care visit:

Hearing

Hearing problems are more likely as you get older but people often wait several years before discussing this with their GP. Problems with your hearing can affect your balance and awareness of hazards thus increasing your risk of tripping or falling. If you notice changes in your hearing, contact your GP.

If you do suffer from hearing loss you may be fitted with a hearing aid which can help restore some, if not all, of your hearing. If you are already using a hearing aid ensure it is working properly.

Action on Hearing Loss provides an advice about Hearing Tests if you are worried about your hearing.

This leaflet: 'Including You' provides more information on hearing loss.

Nutrition and Diet

Keeping your bones healthy is important, regardless of your age. If your bones are strong, there is less chance of you breaking a bone if you fall. As we get older, our bones become thinner. There are a number of things you can do to make your bones stronger. Doing weight-bearing exercises (such as walking), eating a well-balanced diet rich in calcium, limiting how much alcohol you drink and stopping smoking can all help to look after your bones.

Good sources of calcium include:

  • milk, cheese and other dairy foods
  • green leafy vegetables, such as broccoli, cabbage and okra (but not spinach)
  • soya beans and tofu, or soya drinks with added calcium
  • nuts
  • bread and anything made with fortified flour
  • fish with edible bones such as sardines and pilchards

Dementia

Dementia is a term that covers several conditions but what they all have in common is the effect it has on the brain, making it work less well. The effects progress over time but a lot can be done to help people live well with Dementia.

For further information please visit the Living with Dementia in Fife website.

While there is no treatment that will cure dementia, the proactive management of modifiable risk factors can delay or slow onset or progression of the disease.

WHO have developed guidelines to support the reduction of risks of cognitive decline and dementia through a public health approach. As many of the risk factors for dementia are shared with those of non-communicable diseases, the key recommendations are common to frailty and sit behind the MCCNs focus on Healthy Ageing.

Summary of the WHO recommendations.

Other useful websites

Alzheimer’s Scotland provides a range of advice and information for people living with dementia and for relatives/carers living with someone who has dementia. It includes useful information on power of attorney, how to access support and much more.

Care Information Scotland is not specific to one disease, but provides a wide range of information and advice on who to contact if you need help, including navigating the process of assessment, setting up care packages and where to go for financial information.

Medication

It is important to take medicines at the right time of day and in the dose shown in the prescription. However, certain medicines can make you feel faint, dizzy or drowsy. Let your GP or pharmacist know if you ever feel like this – they may want to change the dose you are taking or try a different medicine for you.

Before taking any ‘over the counter’ medicines or supplements that you can buy without a prescription, it is important to check with your pharmacist, as these can also have an effect on other medication you are taking.

There are devices available to support you to manage your medication. Speak to your pharmacist or self assess at smartlifeinfife.org

Chronic Medication Service

The Chronic Medication Service (CMS) allows people with long-term conditions to register with a community pharmacy of their choice for the provision of pharmaceutical care as part of a shared agreement between the patient, community pharmacist and General Practitioner (GP). It introduces a more systematic way of working and formalises the role of community pharmacists in the management of individual patients with long term conditions in order to assist in improving the patient’s understanding of their medicines and optimising the clinical benefits from their therapy.