Small changes today will make life better tomorrow - Dr Lara Mitchell

note-0Frailty isn’t age and it isn’t a disability – note-1it is the marriage of a person’s age-related decline with their physiological reserve. Frailty can have a drastic effect on people living with it, which is why we must do what we can to address and pre-empt it.

While frailty is not inevitable, its impact cannot be underestimated – 50 per cent of people over the age of 85 will live with frailty, while 10 per cent of those over the age of 65 are already frail. Even if a person is frail, it doesn’t mean control is taken away from them and life has to radically change. I fundamentally believe in health and social care in Scotland – it is everyone’s responsibility to work with our older adults to understand their unique needs in order to prevent frailty and halt its progress.

Stop frailty taking hold

Right now, we are making decisions that will affect our future, older selves. Even our attitude towards ageing itself can impact how well we enter our later years. As we age, many of us may become frail, at least to some degree – whether it’s through a loss of mobility, a fall, confusion or the worsening of an existing condition. As a result, frailty reduces our mental and physical resilience to bounce back from acute events, which in turn can have a profound effect on our later years.

Dr Lara Mitchell has been a Consultant in Medicine for the Elderly for 20 years and is the current Clinical lead for Acute Care (Frailty) for Healthcare Improvement Scotland.

Having worked as a Consultant in Medicine for the Elderly for 20 years, I have seen first-hand the positive effect a proactive approach to frailty can have. I can see it with my own parents. Nearing 80, they’ve cycled their entire lives, but have never done any strength or balance work. Following my encouragement, they now go to the gym three times a week and are starting to feel stronger, while experiencing less pain. This has had a knock-on improvement on wellbeing, and enables them to seek out new challenges to test their fitness.

Putting older people in control

On a recent trip to Sweden I learnt of a term that encapsulates this – Arsrika – which means “rich in years”. This concept represents the richness of experience and knowledge that comes in later life, without the loss of dignity, which is really at the core of what we are hoping to achieve. We want to give older adults control of their life back, making sure they feel listened to, and most importantly, heard.

What are we doing about it?

At Healthcare Improvement Scotland, helping to improve care for people with frailty is a key part of our work. We recently launched a change package for health and social care, outlining a framework to support continuous improvement. We’ll also provide an opportunity for teams across acute hospitals, health and social care partnerships and primary care to be part of a national programme to improve care. Its aim is to make sure that people living with, or who are at risk of, frailty, experience improved access to person-centred, co-ordinated health and social care, ultimately improving their lives and bringing that richness to later life.What can we do to improve right now?

If we truly want to make sustainable changes for the better for older people, we must create an environment where we can continually evolve and improve and this starts and ends with understanding what is important to people. They all have their own set of priorities, but the one thing I see again and again is that people want to stay at home and be with their families. Only by being attuned to this, and listening to our older adults’ needs, will we be able to make interventions that have a positive and significant impact on their lives.

It is also vital that older people across Scotland take control of their wellbeing – start today, start small! Even the smallest changes, like going for regular walks, incorporating some strength and balance work, can have a monumental effect on your overall health.

Continuous improvement is like exercise, we know it’s good for us, but need to commit to making it happen. Let’s work together to make healthcare better for our future selves.

Dr Lara Mitchell has been a Consultant in Medicine for the Elderly for 20 years and is Clinical lead for Acute Care (Frailty) for Healthcare Improvement Scotland.