Frailty Test?

[Ton3]

MIL is quite far on in her dementia, not sure how far as its so difficult to guage, (diagnosed in 2018 and sudden downturn August 2020) and is bedbound, still able to feed herself with the odd need of assistance. has very little communication skills and is sleeping much more than ever and also having small fits occasionally as mentioned in a previous post.
Out of the Blue the GP surgery calls and asks if MIL has had a Frailty test done? the answer was no so one is to be arranged.

My question is why now? Looking this up on the internet its the sort of Test that should have been carried out much earlier as MIL is so much obviously Frailer now than she has ever been, My wife has been her full time carer since Sept 2020 and we also have carers coming in 4 times a day to assist with bathing and hygiene needs.
My wife hadnt heard of this test when asked the question so thought it was part of the normal routine because of having carers so she didnt question it.

Has anybody else experienced this Test and if so what does it consist of and was it of any use? MIL cannot walk or carry out any other tasks other than feed herself like dressing. washing etc......

 

[Grannie G]

This is a new one on me @Ton3 in 25 years of living with dementia so I imagine it`s a new test.

What came to mind was the possibility of trying to calculate how many people are being cared for who may be either approaching end of life or who may be on a DNR register.

This is pure conjecture on my part and I do apologise if I’ve caused upset

 

[Ton3]

Hi Grannie G no not at all no upset caused, i was trying to think what it was for and some of the info online was abit vague or full of gobbledygook (dont even know if thats a word! but I say it a lot) I think you may be right and it looks like it was brought in around 2018 however the GP surgery has been slow to activate this as its for all over 65 year olds I believe and MIL is now 79 and its the first we have been asked about it... Will just have to see who turns up to do it and what its all about, thanks for answering, all the best to you....

 

[Grannie G]

One of my friends aged 86 who died not have dementia and is extremely alert was found in her home four days after sustaining a fall and being unable to get up.
She was hospitalised and made a good recovery but was horrified to discover if she had lost consciousness a DNR would have been put in place.

She is now home and well able to look after herself , her only concession being agreement to wearing a care alarm pendant.

I firmly believe everyone over a certain age would be better protected by having an advance directive in place

 

[Ton3]

come to think of it reading both your posts again yes MIL is on a DNR register so that could be why!! Yes DNR is not for everybody yet it seems to being offered a lot more these days??

 

[Banjomansmate]

I think my GP practice ask over 75 year olds if they wish to have a DNAR listed in their records. I’m waiting for the meeting!

 

[Lawson58]

I think my GP practice ask over 75 year olds if they wish to have a DNAR listed in their records. I’m waiting for the meeting!

Do you have to wait for your GP to have that put in place?

I have mentioned it before but I completed an Advanced Care Directive and copies are lodged with my GP and my local hospital. It covers a whole lot more than just DNR. My two children are my decision makers with their consent and any decision has to be made with my treating doctors. It is a legal document and cannot be over ridden.

Nobody can take those wishes from me, even if I develop dementia.

 

[Banjomansmate]

I organised my Advance Directive last year and took a copy to the surgery.

 

[lollyc]

I'm not sure how helpful this is:-
When Mum was discharged from hospital in October 2020 (pelvic fracture), her discharge notes haD a section for "Frailty Assesment and Score in ALL patients > 75years". Unfortunately, it wasn'tcompleted! - but then most of the discharge form wasn't completed.
It seems the scoring goes from 0 (not frail) - 5 (very frail), based on the Abbreviated Fried (not a typo!) Frailty Score.

 

[Lone Wolf]

Here is a common simple Clinical Frailty scale tool. The gp may use a different one. It is worth having done by the gp as it will be helpful evidence if needed in any CHC assessment.

 

[Lawson58]

Here is a common simple Clinical Frailty scale tool. The gp may use a different one. It is worth having done by the gp as it will be helpful evidence if needed in any CHC assessment.

That was interesting, especially the little section on scoring dementia. If I applied that scoring for my husband, he wouldn't fit anywhere!

 

[Jaded'n'faded]

I'm actually surprised they still use a vague word like frail to describe someone's condition.

 

[Palerider]

The clinical frailty scale is widely used across all older people. Frailty in itself is a complex medical condition and assessed both on physical and cognitive abilities.

The tool @Lone Wolf posted is the short version, for a fuller explanation see the link below:

Clinical Frailty Scale — Specialised Clinical Frailty Network

Clinical Frailty Scale

www.scfn.org.uk

 

[Duggies-girl]

I first came across this on a letter from dads oncologist to his GP (Dad was always sent a copy) and I think she scored dad at 8 whereas I would have scored him at 6 as he could still get from his chair to the bathroom or bedroom but he was in a wheelchair when she saw him so that may have been why but all the same he was very, very frail. She said that she did not need to see him again unless we thought it necessary which we didn't. This was around November time and dad died the following February but this was probably due to having cancer as well as dementia.

Looking at the Frailty Scale now I can place my dad in each one starting at 2 ten years ago.

I found the physical changes to be worse than the mental decline as dad shrank considerably from a six foot, 12 and a half stone man to a very small and bent over scrap of bones.

 

[Kapow]

That was interesting, especially the little section on scoring dementia. If I applied that scoring for my husband, he wouldn't fit anywhere!

Well my husband is a 7 on that scoring,and Social services say he is fit to come home from a care home...even though I have said I can't cope...

 

[Sarasa]

Those links were really interesting @Lone Wolf and @Palerider. I can see, if used correctly, it could be a very useful tool.
In your mother in law's case @Ton3 I could see it being used to decide if a trip to hospital if she became ill would be helpful or not.

 

[Duggies-girl]

Those links were really interesting @Lone Wolf and @Palerider. I can see, if used correctly, it could be a very useful tool.
In your mother in law's case @Ton3 I could see it being used to decide if a trip to hospital if she became ill would be helpful or not.

I agree with that @Sarasa as I had already decided along with my brother that we didn't see the point in dad attending regular appointments any more as it was probably doing him more harm than good being dragged out of the house on a pretty pointless expedition to the hospital and he would have been better off snoozing in his chair. Luckily his consultant had the very same thought so we didn't have to suggest it first. It was obvious that he was too frail for any treatment.

 

[Ton3]

Thanks Everybody for your insightful replies, going by the scale MIL would sit between no 7 and 8 and on The severe dementia side. This test is yet to be carried out so lets see what they say?