WHO

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WHOS FRAIL?

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(No Transcript)
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FRAILTY

• irremediable dependence for activities of daily
  living

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WHATS FRAIL?
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FRAILTY DYNAMICS

• The Slippery Slope

capability
illness
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FRAILTY DYNAMICS

• The Slippery Slope

capability
illness
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FRAILTY DYNAMICS

• Natural History

function
time
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• frailty is a life stage which has no successor
• (Paraphrased from Nortin Hadler Rethinking
  Aging)

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FRAILTY DYNAMICS

• Natural History

function
time
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FRAILTY DYNAMICS

• The Slippery Slope

capability
illness
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SO

• FRAILTY CHARACTERISTICS
• 1. impairment/dependence
• 2. cognitive and/or mobility problems
• 3. subject to crisis
• 4. near the end of life

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HETEROGENEITYexample kidney function
Creatinine clearance
age
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• HETEROGENEITY

UNPREDICTABILITY
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SO

• FRAILTY CHARACTERISTICS
• 5. Heterogeneity
• 6. Unpredictable response to medication
• 7. Unpredictable presentation of illness

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Whats aSUNSHINER?

• FRAIL, plus
• I dont want to be a burden on the people I love.
  
• I care more about being comfortable than I do
  about living longer.
• I dont want to take medication (unless I really
  need it).
• I dont want to go to the hospital (unless I
  really need to).

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• SUNSHINERS
• are frail elderly who have made a
• critical decision
• about their future.

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"GERIATRIC GIANTS"

• ORIGINAL BERNARD ISAACS Birmingham
• Immobility and instability
• Incontinence
• Impaired intellect
• (falls, incontinence, and confusion)

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OTHER VERSIONS

• Frailty
• Delerium and Dementia
• Falls
• Medication Issues
• Incontinence
• Cognitive Impairments (i.e. 2 to dementia,
  delirium or depression)
• Incontinence
• Postural Instability and Falls
• Caregiver Stress burnout
• Dizziness
• Iatrogenesis Polypharmacy
• Failure to Thrive (often from the above)
• Frailty
• Elder Abuse

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Todays Topics

• Mobility Failure (Falls)
• Cognitive Impairment
• Incontinence
• Prescribing for the Elderly
• Avoiding Hospital
• ETC.

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ETC

• Permission not to
• Trust and Relationship
• Is Frailty Palliative?
• Population versus Individual
• Prevention with Drugs
• Hospital and Frailty

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