FRAILTY IN OLDER ADULTS: A PROPOSAL FOR THE ADOPTION, IMPLEMENTATION AND EVALUATION OF A FRAILTY ASSESSMENT TOOL IN THE INPATIENT SETTING

Abstract

Frailty is defined as a syndrome in the older adult population characterized by age-related disturbances in homeostasis and diminished physiological reserves and function in various systems. Frail people are at higher risk of developing health problems such as falls, depression, morbidity, mortality, and reduced quality of life. Frailty has been found to be prevalent in many countries around the world. In Lebanon, only one study was conducted regarding the prevalence of frailty, and frailty was found in 48.2% of the participants. The significance of frailty assessment is not only patient and practice directed but it also has an impact on the healthcare system. The objectives of this project are: 1) To identify a suitable frailty assessment tool that can be used in the inpatient setting and 2) to propose a plan for its implementation and evaluation in the medical-surgical units of a university medical center. The proposed plan consists of several stages using Lewin's theory of change as a framework. The literature review revealed the Edmonton Frail Scale (EFS) to be the most appropriate for use for hospitalized older adults considering its psychometric properties, appropriateness for use in acute care settings, and the context of Lebanon. This project provides the structure needed to integrate frailty assessment using the Edmonton Frailty Scale into practice. It involves an assessment of healthcare providers’ knowledge about frailty, the education and training of healthcare providers about frailty and the use of the EFS, and the integration of the EFS in clinical practice. The implementation and evaluation plan for this intervention is described. The execution of this project helps identify frailty in older adults admitted to medical/surgical floors at the American University of Beirut and paves the way for the implementation of frailty management protocols to reduce adverse health outcomes and improve quality of life in older adults.