Frailty can limit a person's ability to maintain the activities and social connections that they have been taking part in their whole life. This loss of independence can increase feelings of loneliness and isolation, having a huge impact on their mental and physical wellbeing. Research shows that living with high levels of social isolation can increase the severity of someone's physical frailty [1].
Supporting people with frailty to live well requires a holistic approach, combining physical, emotional and social support.
Hospice teams can facilitate tailored support to help address people's individual needs and maintain their independence. This might include outpatient wellbeing programmes, as well as community and home-based interventions. With support, people with frailty can carry on doing the things that are important to them, and live well for as long as possible.
Image
"Patients [with frailty] often describe how they are struggling to maintain a sense of independence and control over everyday choices, because of their health problems."
Dr Bethan Haine, Palliative Care Consultant, St Michael's Hospice
How hospices can help
Text
Hospices can provide a tailored combination of physical exercise, advice and emotional support. This can help improve patients' physical and social independence.
Examples of hospice interventions to support independence among patients with frailty are below.
St Barnabas Hospice in Sussex saw positive results after adapting its existing six-week wellbeing programme for people living with frailty. Their new holistic programme covered:
managing fatigue
movement
diet
emotional health
financial advice
planning for the future.
Attendees reported improved physical function after the programme, and also valued the opportunity to connect with others who were in similar situations.
As a result the hospice has made the new Frailty Wellbeing Programme a core part of its outpatient services. After seeing the benefits of peer support, it has also launched a monthly social drop-in session to provide further opportunities for people to connect with each other.
Not everyone living with frailty can attend outpatient programmes due to mobility issues or transportation challenges. In these cases bringing services into their homes can be a lifeline.
For the care provider, seeing patients in their homes can have the added benefit of establishing what type of support they need to manage their daily routines in their home environment.
As part of our Extending Frailty Care project, St Michael’s Hospice in North Yorkshire created a new Care Connector role responsible for delivering personalised care to people in their homes. For up to a period of 12 weeks, the Care Connector conducted one-on-one visits and regular ‘check in’ phone calls.
They helped patients to:
sett individual goals
visit to social groups
arrange meal deliveries
connect with wider services depending on their needs (such as NHS, adult social care and voluntary services).
At the end of the 12-week programme, patients reported feeling empowered to manage their symptoms more effectively at home. Working with the Care Connector also helped them feel able to discuss advance care plans with loved ones.
