Abstract
BackgroundThe Frailty In Residential Sector over Time (FIRST) Study is a 3-year prospective cohort study investigating the health of residents living in residential aged care services (RACS) in South Australia. The study aims to examine the change in frailty status and associated health outcomes.MethodsThis interim report presents data from March 2019–October 2020. The study setting is 12 RACS from one organisation across metropolitan and rural South Australia involving 1243 residents. All permanent (i.e. respite or transition care program excluded) residents living in the RACS for at least 8 weeks were invited to participate. Residents who were deemed to be medically unstable (e.g. experiencing delirium), have less than 3 months to live, or not fluent in English were excluded. Data collected included frailty status, medical diagnoses, medicines, pain, nutrition, sarcopenia, falls, dementia, anxiety and depression, sleep quality, quality of life, satisfaction with care, activities of daily living, and life space use at baseline and 12-months. Data Linkage will occur over the 3 years from baseline.ResultsA total of 561 permanent residents (mean age 87.69 ± 7.25) were included. The majority of residents were female (n = 411, 73.3%) with 95.3% (n = 527) being classified as either frail (n = 377, 68.2%) or most-frail (n = 150, 27.1%) according to the Frailty Index (FI). Most residents were severely impaired in their basic activities of daily living (n = 554, 98.8%), and were at-risk of malnutrition (n = 305, 55.0%) and at-risk of sarcopenia (n = 492, 89.5%). Most residents did not experience pain (n = 475, 85.4%), had normal daytime sleepiness (n = 385, 69.7%), and low anxiety and depression scores (n = 327, 58.9%).ConclusionThis study provides valuable information on the health and frailty levels of residents living in RACS in South Australia. The results will assist in developing interventions that can help to improve the health and wellbeing of residents in aged care services.Trial registrationProspectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000500156).
Highlights
The Frailty In Residential Sector over Time (FIRST) Study is a 3-year prospective cohort study investigating the health of residents living in residential aged care services (RACS) in South Australia
Recruitment Out of 1243 residents who were residing in the 12 services, 1060 (85.3%) residents were eligible for the study (Fig. 2)
It is possible that people are being approved for RACS only at a higher frailty levels given the increased effort at helping older people stay at home longer through community aged care services
Summary
The Frailty In Residential Sector over Time (FIRST) Study is a 3-year prospective cohort study investigating the health of residents living in residential aged care services (RACS) in South Australia. In Australia, research by our team projects that by 2027, there will be approximately 600,000 older (aged 65 years and over) people living with frailty in our community [4]. Those numbers do not account for older people who are home bound or living in residential aged care services (RACS). RACS in Australia are increasingly responsible for individuals with higher frailty scores and in part this relates to government policies directed at supporting older people age in place in the community [5]. We know that older people prefer to stay at home longer and so, increasingly people are being assessed as eligible for RACS with higher frailty scores [6]
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