Our Admiral Nurse was there when nobody else was – Shara’s story
Shara reflects on her journey caring for Anna, her mother, who was diagnosed with vascular dementia in 2016.
Over time, many people with dementia experience physical frailty. This is particularly true for older people, although it can also occur in people with young onset dementia (where symptoms develop under the age of 65).
Understanding, recognising and managing frailty means the person with dementia can access the right care and support and have a better quality of life.
The physical characteristics of frailty are:
As frailty increases, a person will steadily become more vulnerable and will find it harder to bounce back from illness, injury and changes in personal circumstances.
There are three stages of frailty.
A person’s level of frailty can change over time and may improve or worsen depending on what intervention, care and support they receive.
A syndrome is a group of characteristics, symptoms or conditions that typically go together. There are five frailty syndromes; if a person has one or more of these, it is likely that they are living with overall frailty.
The syndromes are:
It is important that healthcare professionals look out for signs of frailty and conduct a proper assessment so that it can be managed well. The signs of frailty may be missed if they are overshadowed by another long-term condition like dementia.
If you have concerns about frailty, the first step is to make an appointment with the GP. They may carry out an initial assessment themselves or refer the person to another professional or service for assessment.
Professionals usually assess frailty using Clinical Frailty Scores/Scales. These assess the person’s degree of fitness and frailty and classify it as mild, moderate or severe.
If a person is identified as frail, they will typically receive a full assessment of their needs, known as a Comprehensive Geriatric Assessment (CGA). Despite its name, this assessment is also used for younger people with frailty.
A CGA is a review of the person’s current symptoms and signs of frailty, taking into consideration any underlying medical conditions. It is carried out by a professional or team of professionals with expertise in frailty.
The person with dementia and their family should be fully consulted and involved in the assessment process.
The CGA is an assessment of the person’s signs, symptoms, and needs in a number of different categories:
There may also be assessments of:
Following a CGA, a care and support plan (CSP) should be formulated, focusing on:
Sometimes, frailty syndromes such as delirium, reduced mobility and falls can mask other underlying illnesses. Knowing that a person has frailty – and ensuring that health professionals are also aware – can help to aid decision-making so they get the right treatment and support, particularly in emergency situations like an unplanned hospital admission.
Frailty is a long-term condition and typically worsens over time. However, some simple lifestyle changes may help a person with frailty function as well as possible.
If you have any questions or concerns relating to dementia, call our free Dementia Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-5pm), email helpline@dementiauk.org or you can book a virtual appointment with an Admiral Nurse via phone or video call.
Our free, confidential Dementia Helpline is staffed by our dementia specialist Admiral Nurses who provide information, advice and support with any aspect of dementia.
Shara reflects on her journey caring for Anna, her mother, who was diagnosed with vascular dementia in 2016.
Richard shares his experience caring for his mother, Peggy, and why he’s chosen to leave a gift to Dementia UK in his Will.
Mahersh opens up on the struggles he and wife Nishma have faced in their attempts to secure CHC funding for his mother’s care.