Frailty. No.

I had intended this blog to focus on my planned trip to India in a couple of weeks; readers will have to wait.

I want to talk about frailty.

For those of you who haven’t kept-pace with my career moves over the past few months, I am now working on the Assessment Unit in Rotherham – quite a change from Mallard. Within this role I am leading the frailty service.

It is frailty that is causing me problems.

We opened the frailty unit in Doncaster three or so years ago, this led to dramatic improvements in the care and experience of older people admitted to hospital, both in relation to reducing unnecessary admission and ensuring that those older folk who are admitted receive world-class person-centred, multidisciplinary assessment and care; all that is good. It is fantastic.

And now, from the peripheries, from my entanglement in the lives of people struggling with the medical complexities of dementia and delirium I am in frailty myself.

And, it is the name that is doing-me-in.

I appreciate doing-me-in isn’t particularly grammatical; it does however represent my relationship with the situation.

Years ago I stopped saying elderly – care of the elderly; that image of unsteady, rickety oldies staggering across Pelican Crossings, dodging traffic, lost on the way to their nursing home, in favour of Older People.

Elderly – a diminutive, diminishing word replaced by Older, something that connotes the relativity of ageing, or experience, growth, maturity.

Now we have frailty.

Yes, it has become a clinical syndrome – a medical term reflecting reduced resilience to illness and disease (the image I have is comparing a fully pumped-up football; bounce, versus, one punctured, deflated – sigh, sag, flop… You get the idea.)

Yet, is it a good way to approach our patients? Is this not imprinting our concepts of deterioration?

You can easily spot a frail person, or so the guidance says – anyone over 65 living in a nursing home, or who has dementia and falls, these are symptoms of reduced resilience, but can’t we take a more positive approach? Pump-up the ball? Patch the puncture?

If we start from a stance of weakness, disability and infirmity we will not necessarily achieve all that is possible; we are likely to remain on the sidelines, watching dust accumulate.

Does changing a name or the way we talk change behaviour?

The answer is yes.

Think Zimbabwe and Rhodesia; think Pro-life and Anti-Abortion, White Supremacy and Britain First, Infection and Sepsis.

Words are our currency; they are how we get along, how we grow, evolve.

Well, Rod, what is your suggestion?

That, I guess is my frustration – I don’t have an alternative, although, why should I? Isn’t this something that we can at least first discuss, gain a better collective understanding then move-on?

I am the frailty nurse/doctor/therapist… Good morning – I am here to help, to collaborate, guide, support, encourage independence, self-determination, growth.

But… I am 90 – what growth?

I think we can all answer that question.

Any thoughts?

The-Story-Teller

8 comments

  1. I’m thinking “vulnerable”, but not gladly. I guess that also imparts a sense of… vulnerability? Tricky one.

    Delicate?

    Exposed? No, scrub exposed… brings up a whole bunch of other images…

    Tender?

    Goodness, this is harder that I thought it would be. Back to the Thesaurus.

    Nigel

    Liked by 2 people

  2. I do not know anyone who wants to be in a Frailty Unit, even in Rotherham.
    I am in my own personal frailty unit at home – keysafe fitted, lifeline on its way, terrified of my own front steps…….
    Recent ambulanceperson (wonderful as they are) rather insistant.
    I feel less able.
    I do not like it.
    Back to the drawing board about a Unit name!
    It is good to occupy my mind thinking about it!

    Liked by 1 person

    • Thanks Freda. There is a whole exploding world of frailty in healthcare – it is the current big thing, and in many respects is effective, powerful and results in improved outcomes for patients – it is just the name that is sticking with me… we have frailty assessments, frailty teams, frailty nurses and… frailty units –

      Liked by 1 person

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