1. age friendly Salford context for Frailty Paul Walsh

2. Global Ageing – Salford Ageing
Increasing population
Changing population

3. People in age friendly places
“An Age Friendly City encourages active ageing by optimising opportunities for health, participation and security in order to enhance quality of life as people age. In practical terms an age friendly city adapts its structures and services to be accessible to and inclusive of older people with varying needs and capacities”.
Global Age-friendly Cities: a Guide (WHO 2007)

4. Priorities for an age friendly Salford

5. Healthy ageing and frailty
Progressive thinking about frailty as an enabler to healthy ageing

6. What do we mean by ‘frailty’? Dr Tim Pattison

8. What is frailty?

9. What is frailty?
“A state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes “
More likely that something will happen to you
You won’t respond to that thing as well as a non frail person
Your outcome will be worse

10. What is frailty?
“A state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes “
More likely that something will happen to you
You won’t respond to that thing as well as a non frail person
Your outcome will be worse

11. What is frailty?
“A state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes “
More likely that something will happen to you
You won’t respond to that thing as well as a non frail person
Your outcome will be worse

12. What is frailty?
“A state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes “
More likely that something will happen to you
You won’t respond to that thing as well as a non frail person
Your outcome will be worse

13. What is frailty ?

14. What is frailty ?

15. What is frailty ?

16. Frailty How can we measure frailty?
Cumulative deficit model (CSHA) 30 variables:
Eg hearing loss, cognitive impairment.
The more deficits the frailer the person

17. Frailty How can we measure frailty?
Cumulative deficit model (CSHA) 30 variables:
Eg hearing loss, cognitive impairment.
The more deficits the frailer the person

18. What can we do?

21. GM recommendations Identify and assess
Identify frailty in >65’s (? eFI) then diagnose using standard tool (e.g. Clinical frailty scale)
Assess for medical/ functional conditions
Assess falls risk and do medication review
Assess frailty in all >65 in urgent/ emergency and share with primary care

22. GM recommendations Identify and assess
Comprehensive assessment (eg CGA) then personal care plan - including , goals of care crisis plan, advanced care plan
Share this plan with the person and health/ social care teams
Support people to self-manage
Single care record visible to health asocial care teams (LHCRE ?)
Crisis response in 2 hours, IMC in 2 days

23. GM recommendations Interventions and care
Group consultations where appropriate
Up to date directory of services
Community based falls prevention for all frail people
All professionals to have frailty training
In secondary care all frail people to be under specialist frailty service