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Case Study Five
Amanda L. Miller
N309 Nursing of the Gerontological Client
February 18, 2012

Case Study Five
	Frailty is defined as the “manifestation of changes in the physiological state of a person and the inability to maintain homeostasis” (Benefield & Higbee. 2007). While Benefield and Higbee describe comorebidity as the occurrence of two or more distinguishably different disease processes in a person, and disability is where someone cannot perform their ADL’s (2007).  All three can lead into one another. For instance, a disease can cause a change in a person physiologic state, leading them to be unable to perform their activities of daily living. However it is important to remember that frailty comes from a multi system of dysfunction while disability is only from a single instability. 
	Frailty is considered a syndrome because it is affecting the multiple parts of the body, impairing the body from regaining homeostasis. 
	Well Mrs. Gibson’s score is that she is a 3. She is experiencing shrinking by her 14 lb weight loss. In strength she is fatigued in physical activity, and she also experiences exhaustion. She has the presence of 3 or more components that identifies fatigue. 
	Benefield and Higbee state that primary frailty is where there is no other thing causing fatigue, while secondary frailty is caused because of something pathological or some other underlying factor (2007).
	The six physiologic-based criteria for risk factors of frailty include the following; activated inflammation, decreased immune function, anemia, endocrine system alterations, and musculoskeletal alterations. 
	The Sociodemographic and psychological risk factors include, female gender, low socioeconomic status, race and ethnicity, and depression. Being female and experiencing frailty might mean that more women experience sarcopenia, where women will have less muscle mass than women, leading to an increased risk of frailty. Being in a lower socioeconomic status has an increased risk for frailty because you do not have the means to be disease-free, and it might mean your lifestyle factors are affecting your chances for frailty. This also leads into race because most frailty is experienced in non-whites. Depression is a risk factor for frailty because in a depressed state, you lose weight and lose sleep, you lose interest in activities, all leading to frailty (Espinoza & Fried. 2007). 
	The risk factors that are not modifiable are those dealing with race and lower socioeconomic status.  Gender, race, age, and socioeconomic status.
Nutritional supplements as an alternative intervention for frailty include
	Vitamin D
	Carotenoids
	Creatinine
	Dehydroepiandrosterone (DHEA)
Tai chi is an appropriate intervention because of its “low risk and ease of participation” (Cherniack, Florez, & Troen, 2007).
	According to Benefield and Higbee (2007)  implementing a universal design for institutions and healthcare agencies will have an environment where exercise training is available involving resistance training to gain muscle, and Tai chi to improve balance and incorporate meditation. Also nutritional supplementation and meals with the essential vitamins and minerals to prevent malnutrition, which could lead to frailty. Socialization, especially during the meal time is important, as well as oral hygiene after meals will ensure that the risk for frailty will be reduced (2007).
 Installing standard electrical receptacles higher than usual above the floor, so they are in easy reach of everyone;
• Selecting wider doors, along with wider hallways; • Making flat entrances; • Installing handles for doors and drawers that require no gripping or twisting to operate—such as louver or loop handles; • Provide storage spaces within reach of both short and tall people;• Minimize the need for staircases; • Any and all procedures, equipment, and strategies promoting safety to avoid falls or injuries.

	

References

Lazelle E Benefield, PhD, RN, FAAN, Rachel L. Higbee, BSN, RN. Frailty and its implications 
	for care. (2007, April ). Retrieved from http://consultgerirn.org/topics/frailty_and_its_
	implications_for_care_new/want_to_know_more
Cherniack, E. P., Florez, H. J., & Troen, B. R. (2007, September). Emerging therapies to treat 
	frailty syndrome in the elderly. Alternative Medicine Reivew, Retrieved from 
	http://findarticles.com/p/articles/mi_m0FDN/is_3_12/ai_n27421818/?tag=content;col1
Espinoza, MD, S. E., & Fried, MD, MPH, L. P. (2007, June). Risk factors for frailty in the older 
	adult. Clincal Geriatrics, 15(6), Retrieved from??????