Kerry Lyons, Consultant Admiral Nurse for Frailty, Dementia UK
Up to half of the population over the age of 85 is impacted by frailty – a long-term condition related to the aging process, in which multiple systems within the body gradually lose their in-built reserves1.
People are living longer than ever. This has led to an increase in complex health conditions experienced in older age, and consequently the number of people living with frailty. It’s an issue which currently costs the UK government in excess of £5billion a year, and still health and social care systems are wholly unprepared1.
During my role as an Admiral Nurse in acute care, I witnessed the struggles and challenges associated with dementia and frailty. Many studies indicate that frailty is associated with a higher risk of developing dementia and living with both, can be incredibly challenging.
I am proud to be taking on the role of Dementia UK’s first Consultant Admiral Nurse for Frailty, supporting professionals who work with people affected by frailty and dementia, to improve healthcare outcomes.
There are three stages of frailty: mild, moderate, and severe. The degree of frailty in an individual naturally varies over time. People living with frailty are less able to adapt to stress factors such as acute illness, injury, or changes within their environment, personal or social circumstances, and such changes are more likely to result in adverse health outcomes and/or a loss of independence.
People living with this condition may not consider themselves as frail, and often describe themselves in other ways, such as ‘slowing down’. Frailty often goes unidentified, unless actively sought out through an assessment. This results in many missed opportunities to improve outcomes for families affected by frailty occurring alongside dementia. In acute settings, a person living with dementia and frailty is more susceptible to developing infection and illness – knowing a person has frailty can be the key to really understanding the person’s clinical vulnerabilities.
In March 2020, when Covid-19 was prevalent, I supported a 76-year-old man who was living with vascular dementia and frailty. He had been admitted to hospital with a severe chest infection. His wife was his main carer but was not allowed to visit him in hospital due to the lockdown restrictions. This caused them both huge distress.
As their Admiral Nurse, I worked alongside the family to ensure that the care received was tailored to the man’s complex needs. I also worked closely with the medical professionals caring for him to make sure that there was a clear communication strategy in place, so they fully understood his condition and care requirements. It was also important that his wife was kept informed and that she was given regular opportunities to speak with him, so I set up daily FaceTime and telephone calls for them.
During one of my regular visits, I noticed that his health had significantly deteriorated. I worked alongside the professionals in charge of his care to initiate an urgent investigation. The results showed that he had developed sepsis. Through one-to-one support and collaborative care, we were able to identify and treat his condition in its early stages, managing future potential health risks associated with frailty.
As his condition improved, I met with a social worker in the hospital to discuss the requirements for his arrival home. We arranged a social care package including a referral to a physiotherapist to assess and support his mobility, and a meeting with a speech therapist to advise and guide his swallowing. The discharge plan gave his wife, his primary carer, the confidence to care for him. My experience with frailty was vital for supporting his stay in hospital, including mitigating potential health risks, and aiding the transition of discharge.
Dementia is a huge and growing health crisis. For a long time now, people living with dementia and frailty have been failed by the health and social care systems, which has led to poorer health outcomes and more distress for family members and loved ones involved.
Our Admiral Nurses are working hard to improve frailty provision, and we are working with other healthcare professionals to deliver training and advice; this will be central to my role a Consultant Admiral Nurse for frailty. However, there aren’t enough Admiral Nurses to reach every family that needs support. It is vital that we build a person-centred healthcare pathway – a wraparound system of care which will help people age well and live well at home for longer. In the future, I hope to see an increase in one-stop frailty clinics and community-based ambulatory care hubs and clinics, to improve patient experience and ease pressure on stretched services.
For families affected by dementia, Admiral Nurses can be a lifeline. Without them, many families would be left to struggle alone and unable to manage complex needs. To find out more about becoming an Admiral Nurse, speak to the team at Dementia UK by emailing admiralnurserecruitment@dementiauk.org
If you need advice or support around dementia, you can visit dementiauk.org/get-support for information resources and to find out how to access Dementia UK’s national Helpline and Clinics services.
References
1 https://www.bgs.org.uk/sites/default/files/content/attachment/2023-03-06/BGS Joining the Dots – A blueprint for preventing and managing frailty in older people.pdf
