Beginner’s Guide to Frailty in the Elderly

With age comes several body changes that we need to keep up with to prevent dangerous situations or injuries, such as bone fractures and falls. One of the most common developments is frailty, which is where a person’s physical and mental resilience isn’t able to bounce back as quickly as it used to.

The term frailty is usually misunderstood, as many people think it only refers to weaker bones and longer recovery times from injuries. However, mental well-being can become more fragile as you age, leading to difficulties accepting new limitations and the challenges of getting older.

In this guide, we’ll explore everything you need to know about frailty in the elderly, including what it is, how to continue living life to the fullest despite it and how to reduce risks for loved ones living with frailty.

What exactly is frailty?

The definition of frailty is: the condition of being weak or delicate. For this reason, older people might associate being called ‘frail’ with negative thoughts and emotions – but this shouldn’t be the case at all. When referring to people, frailty actually describes someone’s overall resilience and how this affects how quickly they can recover after certain health problems.

For example, being frail often means that if you were to have a relatively ‘minor’ health problem, like a urinary tract infection or common cold, it may impact your future health and well-being more than it should.

Age UK reports that around 10% of people over the age of 65 live with frailty, with this figure increasing to between 25% and 50% for those aged over 85. It’s important to realise that being frail isn’t the same thing as living with long-term health conditions, like osteoporosis, severe mental illness and diabetes, but there may be some overlap with frailty being a by-product of these progressive conditions.

How to spot the signs of frailty in the elderly

Frail people often find it increasingly difficult to complete everyday tasks, meaning that they might require more assistance with things they used to have no problem with. Examples could be getting out of bed, moving around their home or using the bathroom. They might be at a higher risk of falling and injuring themselves, so it’s important to know the signs of frailty to keep them safe.

If you or your loved one has more than three of these potential signs, you may be considered frail:

• Weight loss: An unintentional reduction in weight of 10 pounds or more in the last year
• Feeling weak: Trouble standing or walking without assistance from someone else
• Reduced grip strength: Difficulties holding things like a cup, ball or walking stick without your hand coming loose and it falling
• Exhaustion: Feeling like completing each task takes a huge amount of effort, or struggling to keep yourself motivated and moving
• Less active: A noticeable drop in how much you exercise or move around the house
• Slowed down: Walking much slower than you used to, where it takes you more than 6 seconds to walk 15 feet

What causes frailty in older adults?

Several things cause frailty in older adults, from age to chronic conditions. It’s often tempting to dismiss frailty as a simple fact of life, but this doesn’t always have to be the case. Sometimes, there’s a treatable reason behind frailty, and it improves after the cause has been treated.

Here are some potential causes of frailty in the elderly:

• Age: The most common cause of frailty is getting older, as this changes the entire way your body functions. You may become slower, feel more aches and pains or take longer to do things. The more we slow down, the easier it is to remain at this new pace – leading to a higher chance of remaining frail.
• Diseases: Certain medical conditions, like dementia, diabetes and depression, can increase the chance of frailty. For example, type 1 diabetes is associated with lower bone density, increasing the risk of fractures.
• Chronic conditions: Chronic conditions lead to intense inflammation or immune system activation. This is the body’s way of fighting against things that threaten it, such as infections, injuries and toxins. Inflammation occurs more frequently in frail people, creating an ongoing strain on the body, reducing muscle and heart function and causing conditions like anaemia.
• Loss of muscle mass (sarcopenia): Losing muscle mass and strength is one of the most common causes of frailty, as it weakens the body and makes it more difficult for it to bounce back after being hurt. Decreased hormone levels often make frailty more severe.

Living with frailty: caring for a frail older adult

When dealing with frailty, one of the most important things is to adapt to living with it and find new ways to handle day-to-day tasks. There’s no other way around it: frailty can be a huge challenge to someone’s self-worth, mental health and how they’re treated by others. Learning to live with frailty rather than ignoring it will help you come to terms with your new normal.

Here are some simple tips to help a loved one cope and live well with frailty:

Keep active and alert

frailty makes our bodies tired, and even small amounts of exercise have a lasting impact on the rest of the day. When this happens, it’s easy to retreat to a comfy chair and stay there, but inactivity can fast-track the frail process and result in quicker muscle loss in the legs, arms and heart.

Most healthcare professionals recommend staying active at home as much as possible. This doesn’t mean strength training and cardio workouts – taking the stairs, moving between rooms and getting outside for fresh air are usually enough.

If your loved one can’t get out of their chair without assistance or move through their house confidently, they may need additional support in the form of a carer or mobility assessment. Talk to your loved one’s GP to organise this, as well as extra aids to help them maintain their independence.

Fuel your body

Weight loss is a common characteristic of frailty as the muscles become thinner and weaker, further exacerbated by the reduced appetite many seniors experience. Try offering your loved one three small meals a day, as well as nutritious snacks in between, to keep them replenished and strong.

Good food does wonders for both the body and mind, helping with emotional regulation as well as physical changes. If they’re still struggling to get their calories or enough protein in, consider talking to your loved one’s GP about nutritional supplements.

Request a medication review

Frail elderly people may become sensitive to medications because the body finds it increasingly difficult to get rid of them. This means that a normal dose of medicine can build up in the body, causing an adverse reaction and further boosting the symptoms of frailty.

6.5% of hospital admissions for seniors are due to adverse drug reactions, according to NHS England. Medications like nitrates, calcium channel blockers, ACE-inhibitors, angiotensin receptor antagonists and diuretics are common antagonists for falls, while opiate analgesia and benzodiazepines may increase the risk of delirium. Both falls and delirium contribute to feelings of fatigue and frailty.

If you think your loved one’s medications are influencing their well-being to the point of putting them in danger, request a medication review with their healthcare provider.

Don’t underestimate Vitamin D

Vitamin D is somewhat of a wonder drug for elderly adults thanks to its benefits, and it can also be a great help for those with frailty. Supplementing with a Vitamin D and calcium combination tablet boosts your loved one’s intake of both, and has been associated with a reduced risk of falling in housebound older people.

Vitamin D is also obtained from sunshine, fatty fish, egg yolks and fortified foods. Milk, yogurt, leafy greens and canned salmon with bones are excellent sources of calcium.

Consider companionship

Frail older people may find themselves becoming housebound, which increases the chances of feeling lonely and isolated astronomically. If left unchecked, these feelings can then spiral into depression, impaired thinking skills, poor sleep and a higher risk of falls.

Families aren’t always able to be around their frail loved ones’ home 24/7, but there are ways to minimise how much time they’re spending alone. Create a visiting schedule among friends and family, temporarily move in with them or check out companionship care from a live-in carer. Doing so reduces their risk of loneliness and the dangers associated with it, as well as giving you peace of mind that they’re with someone should anything go awry.

For more information on companionship care at home, download our live-in care guide, where you’ll find plenty of information on our services and what our carers can do for you.

Ways to reduce risks for frail adults at home

A home carries plenty of risks for older people who perhaps can’t move as easily as they used to, but don’t jump to downsizing or residential care homes just yet. There are several practical ways to create a safer space for your loved one that lets them stay in their familiar surroundings for longer.

Here’s how to reduce the risk of accidents and injuries in your loved one’s home:

Remove clutter and furniture to create wider pathways

Take a wander around your loved one’s home and check for anything that may get in their way of their moving from room to room. Pay attention to wires, loose carpet or rugs and small furniture that could be a tripping hazard. Rearrange these spaces to make sure they have clear, wider pathways, especially if they need aids like a walking frame or wheelchair.

Install handrails and grab bars

Sometimes, frail adults need something to hold onto as they move around their house. Installing grab bars and handrails by the stairs, toilets and doors offers instrumental support when standing, moving or looking after themselves. These additions can reduce the risk of falls and boost their independence.

Add extra lighting options to boost visibility

Some rooms, like hallways and bathrooms, may not be very well-lit, especially during the winter or at night. Not being able to see where they’re going could greatly increase the risk of injury for your loved one, so make sure all rooms are bright with motion-sensor, extra-bright lights.

Use non-slip flooring where possible, especially in bathrooms and kitchens

Carpets can be trip hazards, which is why most older people choose hardwood or linoleum flooring. However, these may become slippery when wet, so we recommend using non-slip mats and flooring wherever this is a risk. Bathrooms and kitchens are particularly susceptible to water spills, so pay close attention to these rooms.

Keep their favourite things and essentials close by

If your loved one has to stretch or climb to get things that they want or need throughout the day, their risk of hurting themselves may increase. Keep their favourite things in baskets near their chair or bed to avoid this, so they’ll have everything they need throughout the day within reach.

How Trinity Homecare can help

At Trinity Homecare, we understand how challenging frailty can be for both older adults and their families. The increased risk of falls and injuries puts a strain on everyday life, especially when they’re living alone. Our live-in and visiting carers can reduce this worry by offering companionship, helping with daily tasks and monitoring your loved one’s health.

The care we provide includes:

• One-to-one support at home
• Completely bespoke live-in care tailored to you
• Specialist care for a number of different circumstances
• Home carers carefully matched to your needs
• CQC rated ‘Outstanding’ live-in care services

With more than 25 years of experience, we pride ourselves on providing the highest standards of care services to our clients. Our expert carers are fully trained and know what to look out for in frailty among seniors, giving you peace of mind that your loved one is in good company when you can’t be there.

Talk to us today

If your loved one requires home care, chat with one of our friendly care team today. We offer a free, no-obligation enquiry and assessment service and are happy to offer information and advice to help you find the perfect home care solution.

Call us on 020 4572 5583 in confidence for a free no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.