ALL HANDS ON DECK TO TACKLE FRAILTY
This scenario is becoming increasingly common in Singapore as more elderly residents live alone, either from a strong preference for independence and reluctance to burden their families or due to a lack of a close network of support from family or friends.
Not everyone who is frail regains their function like Mdm M and many end up needing some care support or having to make new living arrangements. A handful stay longer than needed in the hospital as they await long-term care placements, which are also limited across the island.
In the long run, other than having better acute care for frail patients in the hospital, the momentum needs to be continued when they are back in the community. Ultimately, the goal is to have in place an integrated and coordinated support system so that frail seniors age in place as much as possible, in an environment they are familiar with.
After her discharge, Mdm M underwent rehabilitation sessions in the Day Rehabilitation Centre. She also now frequents the Active Ageing Centre near her home and participates in a variety of activities that she enjoys.
Frailty is a complex, multidimensional syndrome. Delivering quality healthcare to frail older adults requires a vastly different approach from the single-disease model.
In addition to addressing frailty when patients arrive at the hospital’s doorstep, having community-based prevention programmes will promote early detection and facilitate implementation of interventions such as nutrition, physical activity, and social support – key elements in preventing or slowing down the progression of frailty.
Developing a health and social care system conducive to the care of frail older adults is an important step towards improving their well-being and helping them achieve the holy grail of healthy ageing.
Dr Tan Huei Nuo is Head of the Department of Geriatric Medicine in Tan Tock Seng Hospital and chairs the hospital’s Frailty-Ready Hospital framework.
Jasmine Kang is Deputy Director of Nursing in Tan Tock Seng Hospital and a Geriatric Advanced Practice Nurse. She leads the framework for inpatient care of the frail elderly workgroup in the hospital’s Frailty-Ready Hospital steering committee.
Dr Chen Wei Ting is Deputy Director for Community Health at the National Healthcare Group. She leads NHG Community Health Teams in providing frailty management programmes in the community.