Raising awareness for frailty in community dwelling elderly. First experiences of a frailty initiative by physical therapists in collaboration with municipal services.

Abstract

Background: Falling in the elderly is a global health concern. A subgroup of elderly, i.e. those who are considered as frail, is at increased risk for falling. The prevention of falling is necessary to reduce its physical, psychosocial and socioeconomic impact. Health care providers in primary care are well positioned to reach this population. They can play an important role in informing and advising elderly and to raise awareness at an early or pre-frail stage. Pre-frail elderly, however, do not always visit care providers. Yet, they are the target group. To be able to reach them in a targeted way, the help of municipal services can be called in.
 Objective: To analyze how a frailty screening can be organised successfully by physical therapists and municipal services.
 Methods: Pre-frail community dwelling elderly (> 70 y old) in the community of Beveren, Antwerp, Belgium were invited for a frailty screening via the municipal information brochure and flyers. It was organised on two mornings between 9.00 h – 13.00 h. The screening consisted of the filling out of questionnaires (Short Falls Efficacy Scale-I, EuroQuality of life-5D, 1Minute-Osteoporosistest, Sarc-F(Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls), Self-reported history of fall incidents and dizziness), supervised by a community nurse or psychologist. Next, five physical tests were performed, supervised by physical therapists: Short Physical Performance Battery, Hand Grip Strength, Functional Reach Test. Lastly, an audiogram was taken by an audiologist. At the end of the screening all test results were discussed in a one-to-one conversation. All participants received tips, tricks and advise based on their personal situation. Additionally, general information on staying healthy and active was available.
 To increase the number of participants, the tests were held in a public place and free public transport was provided for those in need of it. Other health care providers such as general practitioners, dietitians, healthcare promotors were informed about this screening initiative.
 Results: In the community of Beveren (49.000 inhabitants, spread over an aera of 150 km²) we reached in two screening-moments 20 and 38 community-dwelling elderly. Relatively healthy elderly were present. 4 used the free public transport. We were able to screen and inform 58 persons on 7 hours. All participants were positive about the initiative and were open to the provided information.