Our health care system is generally set up for addressing one health issue at a time, using a standard approach to care derived from studies where patients generally have only one, or few, health issues. This model doesn't work well for frailty. People who are frail often have multiple, chronic progressive health issues, and multiple competing causes for symptoms and mortality. Fixing one health issue using the “standard of care” approach may make other health issues, or overall function, worse (Mallery & Moorhouse, 2011).
An increasing prevalence of frailty may help to explain several trends you’ve been seeing in your work such as long waits for surgeries and other procedures, falls, adverse drug reactions, delirium, etc.
Prior to 2014, there was no formal integration of frailty-focused projects and initiatives within NSHA-Central Zone. Leadership's awareness and recognition of frailty-driven pressures on sustainability within the health system resulted in the identification of a need to implement structures to support persons experiencing frailty.
The NSHA Frailty Strategy was developed with a focus on:
Optimize experience in frailty
The strategy recognizes that frailty touches a broad range of people — pre-frail/frail persons, family and friend caregivers, family members, providers (physicians, nurse practitioners, pharmacists, allied health care professionals, paramedics, etc.), and the community sector (private facilities, services and businesses, housing authorities, legal community, community groups and organizations, church/faith communities, Government, academic institutions).
We want to meet people experiencing frailty where they are at, empower them with knowledge about frailty, and offer appropriate supports and timely care. This will involve embracing difficult realities. The strategy acknowledges the need for supports and approaches to care that are designed to be flexible and to travel through transitions in health with persons experiencing frailty. This requires everyone working together - patients, families, family and friend caregivers, and health care providers.
These six areas will guide current and future initiatives:
* Stakeholders include persons living with frailty, families, family and friend caregivers, providers, community organizations, businesses, government and academic institutions . ** Persons experiencing frailty includes patients, clients, family and friend caregivers.
The term "frailty" exists in the public domain. It has many connotations, including unflattering ones. In order to achieve the vision guiding our strategy, all NSHA Staff & Physicians must share a common understanding of what it means to be frail. From there, we will be better positioned to promote its medical meaning within our care settings.