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Did you know that 1 in 4 Algoma adults ages 65+ are living with frailty?
Algoma’s older adults are a diverse generation rich in history and expertise. Within this generation are over 7,000 individuals living with frailty, a geriatric syndrome characterized by reduced strength, endurance, and physical function.
Frailty can be characterized by experiencing at least three of five of the following symptoms:
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Low grip strength
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Low energy
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Slow walking speed
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Low physical activity
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Unintentional weight loss
When an individual is frail, their body can’t cope with stressors and illnesses in the same way that it would for an individual who isn’t frail. Minor stressors can have a major impact on the body and result in rapid declines in overall health. (Canadian Frailty Network, 2020)
Frailty can lead to:
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Functional decline
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Falls
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Health service use
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Caregiver fatigue and stress
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Rapid deterioration as a result of generally minor illnesses like the flu
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Institutionalization
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Death (NESGC, 2020)
Algoma’s older adults living with frailty, especially those who have potential to improve with intervention, are one of the first groups we hope to positively impact through our projects. To do this, we’re bringing together local and regional health professionals to co-design improved care pathways for older adults living with frailty.
Areas for improvement:
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Eliminating or reducing the number of falls and functional losses
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Focusing on the restorative potential of older adults
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Implementing proactive, early models of care in order to restore independence
Aging and Frailty in Algoma
Aging does not necessarily mean that someone is or will become frail, but it does increase the odds of developing frailty. Whether or not someone develops frailty is impacted by several factors, many of which can be reduced through intervention:
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Inactivity
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Poor nutrition
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Taking multiple medications
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Social isolation or loneliness
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Other biological and socioeconomic factors
As our population of residents over 65 grows, so will the population of Algoma adults experiencing frailty. The Provincial Geriatrics Leadership Office (PGLO) predicts that by 2040, almost 11,000 Algoma residents will be living with frailty (see graph).
The World Health Organization (WHO) defines healthy aging as “the process of developing and maintaining the intrinsic capacity and functional ability that enables well-being in older age”.
Through our projects, we aim to contribute to the healthy aging of our older adults and enable them to continue to thrive – to learn, grow, make decisions, be mobile, maintain relationships, and contribute to society.
Post-fall Pathway
In Algoma, falls are the most common reason for injury-related hospitalization. In 2018-19, over 1500 patients ages 65+ visited the Sault Area Hospital Emergency Department after a fall – with more than 98% of these having occurred as a slip, trip or “from the same level”.
One of our projects will focus on improving outcomes for older adults at risk for falls related to frailty using the Rehab Care Alliance (RCA) Pathways.
These pathways include evidence-based information for primary care providers and emergency departments on how to connect frail older adults who fall with rehabilitative care to prevent additional falls and further functional decline. The RCA pathways use the Clinical Frailty Scale, which reflects levels of frailty and influences how older adults receive care via the RCA pathways.
PROJECT TEAM
Project Lead: Victoria Aceti Chlebus (Director, AOHT)
Physician Leads: Dr. Winyan Chung (Family Physician; Algoma District Medical Group/Group Health Centre) and Dr. Katriina Hopper (Geriatrician, Head of Geriatrics; Sault Area Hospital)
Working Group Members: Dana Corsi (Regional Geriatric Rehab Lead; North East Specialized Geriatric Services), Tracy Byron (Algoma SubRegion Senior Friendly Care Lead; North East Specialized Geriatric Services), Jack Willet (Manager, Emergency Department; Sault Area Hospital)
Resources
Algoma Community Health Profile
Algoma Public Health, 2018
New resource on rehabilitative care for OHTs
Rehabilitative Care Alliance 2020
Support for Ontario Health Teams in Caring for Older Adults: Full Application Stage
Regional Geriatric Programs of Ontario
Canadian Frailty Network