IDENTIFYING AND MANAGING FRAILTY

SHE Level 3
SCQF Credit Points 20.00
ECTS Credit Points 10.00
Module Code M3B726217
Module Leader n/a
School School of Health and Life Sciences
Subject Nursing
Trimesters
  • A (September start)
  • B (January start)
  • C (May start)

Summary of Content

This theory-based module aims to develop the knowledge, skills and attitudes required when working with frailer older people, and those transitioning to frailty. It aims to provide skills to identify and recognise frailty and reduce risk of or manage the impact of frailty on wellbeing and quality of life in older adults. Frailty is a common condition among older people and presents a global social and health challenge. Frailty is not only costly in terms of medical costs, but also imposes a mental and financial burden on the family members of older people with the condition. A person with frailty is also at an increased risk of disease, disability, falls and death. However, frailty is reversible. Preventing frailty is an important target in the promotion of healthy ageing. Managing and treating frailty is a key component in the care of older people. Students will study and explore guidelines and recommendations which promote multidisciplinary frailty risk assessment and intervention and also dedicated guidelines for prevention and management. Students will also gain an understanding of the development of prevention/management programmes in a wide range of settings (acute, community based, care homes) and with a wide range of older people, with direct practical issues discussed. Finally, students will gain an understanding and experience of community engagement and develop motivational skills for work with frail older adults. It capitalises on the extensive research and practice strengths of staff within the Division.

Syllabus

All topics will cover the functional/health range seen in older adults and will cover those living independently, receiving care in the home and those living in residential settings (sheltered and nursing care) or hospital settings. The module syllabus will include new developments in research and practice in falls and frailty and will also include; -284 Scottish government and British Geriatric Society priorities concerning older people who require intervention in health and social care Frailty - definitions measurement tools and current concepts (physical, mental, social) Syndromes of Ageing (Geriatric Giants/5Ms) and Multiple Co-morbidities Medications and inappropriate prescribing in advanced frailty Falls and falls prevention - contemporary research and practice Nutritional and hydration interventions to reduce frailty - the evidence and key factors for success Cognitive and Sensory impairments in frailty/falls The roles of nurses, different AHPs and others working with frailer older adults and those with a history of falls - Inter-professional working (delivered by Physio/OT/Nurse/Radiographer/Podiatrist/Psychologist/Social Work) The syllabus on this module will prepare students to develop GCU's four 'Common Good Attributes' (Active and Global Citizenship, Entrepreneurial mind-set; Responsible Leadership and Confidence; to equip students to make a positive difference to the communities they will serve. Throughout the syllabus this module seeks to identify opportunities for change and create sustainable solutions that can be put into practice in relevant contexts and make a positive difference to older people at a local and national level.

Learning Outcomes

On successful completion of the module the student should be able to:1. Appraise the impact that frailty can have on the well-being of the older adult.2. Analyse the evidence for risk factors for frailty, linking physical, cognitive and functional outcomes in older and frailer older adults with multiple co-morbidities.3. Analyse the policy context for frailty and the key strategic documents that will guide intervention.4. Appraise the facilitators and barriers to engaging in exercise and nutritional/hydration interventions in different contexts.5. Define and explain the role of different multidisciplinary team members, volunteers, family and significant others in the engagement and motivation of older people to self-manage frailty.6. Define and critically explore person-centred interventions for those who are frail.

Teaching / Learning Strategy

This module will be delivered using a blended learning approach involving face to face learning accompanied by online activities, seminars, tutorials and discussion boards. Students will also be supported in their self-directed learning, to achieve the above outcomes. A range of experts, including clinical academic practitioners from a number of relevant disciplines and partners from local NHS Boards will contribute to the delivery of the module and support the learning activities. Lectures will be used to present key terminology and theoretical arguments and will offer the opportunity to develop knowledge and understanding of the concepts and ideas associated with the topic area. Lectures will be accompanied by activities designed to enhance understanding. Online seminars will be used to supplement learner understanding of lecture materials using more interactive methods of learning, including small-group discussions and presentations to peers. Such sessions will provide opportunities for students to reflect on learning, as well as assessment in both a formative (group presentation) and summative nature.

Indicative Reading

-360b7 BRITISH GERIATRIC SOCIETY. FIT FOR FRAILTY. GOOD PRACTICE GUIDE. 2014. Available at <https://www.bgs.org.uk/resources/resource-series/fit-for-frailty> b7 TINETTI M, HUANG A, MOLNAR F. The Geriatrics 5M's: A New Way of Communicating What We Do. J Am Geriatr Soc. 2017 Sep;65(9):2115. doi: 10.1111/jgs.14979. Epub 2017 Jun 6. b7 LIM SH, ANG SY, ABU BAKAR ALOWENI FB, d8STBYE T. An integrative review on screening for frailty in acute care: Accuracy, barriers to implementation and adoption strategies. Geriatr Nurs. 2019 Jul 3. pii: S0197-4572(19)30261-7. b7 TOLSON D, BOOTH J, SCHOFIELD I, Eds. Evidence Informed Nursing with Older People. Wiley Blackwell Publishers, Chichester. 2011. b7 BRUCE J, LALL R, WITHERS EJ ET AL on behalf of PreFIT Study Group. A Cluster Randomised Controlled Trial of Advice, Exercise or Multifactorial Assessment to Prevent Falls and Fractures in Community Dwelling Older Adults: The Prevention of Falls Injury Trial (PreFIT). BMJ Open. 2016 Jan 18;6(1):e009362. b7 KOJIMA G, ILIFFE S, MORRIS RW, TANIGUCHI Y, KENDRICK D, SKELTON DA, MASUD T, BOWLING A. Frailty predicts trajectories of quality of life over time among British community-dwelling older people. Qual Life Res. 2016 Jul;25(7):1743-50. b7 KOJIMA G, KENDRICK D, SKELTON DA, MORRIS RW, GAWLER S, ILIFFE S. Frailty predicts short-term incidence of future falls among British community-dwelling older people: a prospective cohort study nested within a randomised controlled trial. BMC Geriatr. 2015 Dec 2;15:155. b7 SANDLUND M, SKELTON DA, POHL P ET AL. Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review. BMC Geriatr. 2017 Feb 17;17(1):58. b7 BJERK M, BROVOLD T, DAVIS JC, SKELTON DA, BERGLAND A. Health-related quality of life in home care recipients after a falls prevention intervention: a 6-month follow-up. Eur J Public Health. 2019 Jun 6. pii: ckz106. doi: 10.1093/eurpub/ckz106. [Epub ahead of print] b7 DE JONG LD, LAVENDER AP, WORTHAM C, SKELTON DA, ET AL. Exploring purpose-designed audio-visual falls prevention messages on older people's capability and motivation to prevent falls. Health Soc Care Community. 2019 Jul;27(4):e471-e482. b7 STANMORE EK, MAVROEIDI A, DE JONG LD, SKELTON DA, ET AL. The effectiveness and cost-effectiveness of strength and balance Exergames to reduce falls risk for people aged 55?years and older in UK assisted living facilities: a multi-centre, cluster randomised controlled trial. BMC Med. 2019 Feb 28;17(1):49. b7 PETTERSSON B, WIKLUND M, JANOLS R, LINDGREN H, LUNDIN-OLSSON L, SKELTON DA, SANDLUND M. 'Managing pieces of a personal puzzle' - Older people's experiences of self-management falls prevention exercise guided by a digital program or a booklet. BMC Geriatr. 2019 Feb 18;19(1):43. b7 KIDD T, MOLD F, JONES C, ET AL. What are the most effective interventions to improve physical performance in pre-frail and frail adults? A systematic review of randomised control trials. BMC Geriatr. 2019 Jul 11;19(1):184. b7 O'CAOIMH R, CORNALLY N, MCGLADE C, ET AL. Reducing inappropriate prescribing for older adults with advanced frailty: A review based on a survey of practice in four countries. Maturitas. 2019 Aug;126:1-10. b7 FALLER JW, PEREIRA DDN, DE SOUZA S, ET AL. Instruments for the detection of frailty syndrome in older adults: A systematic review. PLoS One. 2019 Apr 29;14(4):e0216166.

Transferrable Skills

Development, or enhancement, of; -360b7 Independent learning skills b7 Critical thinking and decision making skills b7 Study, IT and time management skills b7 Professional and ethical values aligned with professional practice b7 Communication (oral and written) and team working b7 Theory and practice integration and problem solving b7 Reflection b7 Assess motivation and capacity for behaviour change and clearly explain cause and effect relationships b7 Solution focussed therapies and positive behaviour support approaches

Module Structure

Activity Total Hours
Assessment (FT) 20.00
Tutorials (FT) 12.00
Lectures (FT) 12.00
Independent Learning (FT) 144.00
Seminars (FT) 12.00

Assessment Methods

Component Duration Weighting Threshold Description
Essay n/a 100.00 40% Essay (3000 words)