14/15

Good job

Case Study 5.2
Simone Walker
Lakeview College of Nursing
Nursing of the Gerontological Client
February 17, 2012

Case Study 5.2
1. Compare and contrast the definitions for frailty, disability, and comorbidity. 
     Frailty is the manifestation of changes in the physiological state of a person and not able to maintain homeostasis. Comorbidity is the occurrence of two or more distinguishably different disease processes in a person. Disability is the inability to carry out activities of daily living (Benefield & Higbee, 2007). Frailty, comorbidity and disability all have in common that it affects the individual in some way. They differ on effects are happening to the individual.
2. Explain why frailty is considered a syndrome.
    Frailty is considered a syndrome due to the reduced functional reserve, impairment in multiple physiological systems, and reduced ability to regain physiological homeostasis (Benefield & Higbee, 2007).
 A syndrome involves a set of symptoms occurring together. In the case of frailty,
the syndrome entails reduced functional reserve, impairment in multiple physiological
systems, and reduced ability to regain physiological homeostasis
3. View the frailty assessment tool and determine Mrs. Gibson’s actual score.
    Mrs. Gibson’s score is 3.
Mrs. Gibson’s score on the frailty assessment tool is a “3” as she has experienced
a weight loss of 14 lbs, has the presence of fatigue, low physical activity and no
longer can ambulate.
4. Differentiate primary versus secondary frailty.
    Primary frailty has no underlying, pathological causative factors, and secondary frailty originates from underlying, pathological causative factors (Benefield & Higbee, 2007).
5. What criteria comprise the six physiologic-based risk factors for frailty?
    The six physiologic-based risk factors for frailty are distinct physiologic entity with characteristics changes in physiology, including activated inflammation, decreased immune function, anemia, endocrine system alterations, and musculoskeletal alterations (Espinoza & Fried, 2007).

6. Discuss the sociodemographic and psychological risk factors presented in the article. 
    The sociodemographic risk factors are people who have lower socioeconomic status, as measured by low education and/or low annual income, high BMI, ethnicity, tobacco use, alcohol use, self-reported health, and comorbid conditions (Espinoza & Fried, 2007). The psychological risk factors of frailty are psychological well-being has long been associated with the idea of “successful aging,” and that depressive symptoms have been shown to be associated with frailty. A study found a relationship between depressive symptoms and the onset of frailty, suggesting that depression may contribute to frailty. This is based on the fact that depression or depressive symptoms can lead to frailty is biologically based, given that individuals with depression often lose weight, become less active, and therefore they can lose muscle mass, strength, and exercise tolerance, and can be more prone to acute illness (Espinoza & Fried, 2007).
Sociodemographic and psychological risk factors include female gender, race/
ethnicity (nonwhite), socioeconomic status reflected by low annual income and
education, and depression.
7. Which of the risk factors reviewed for frailty would not be modifiable?
     The risk factors that cannot be modifiable is race and socioeconomic status (Espinoza & Fried, 2007).
Gender, race, age, and socioeconomic status
8. Nutritional supplements as an alternative medicine intervention for frailty includes the following: (select all that apply)
      a. Carotenoids
      b. Vitamin D
      c. Probiotics
      d. Creatine 
      e. Dehydroepiandrosterone (DHEA)
Answers: A, B, D, E

9. Using the same Internet source, discuss how tai chi may be an appropriate intervention.
    Tai chi is an appropriate intervention because it improves postural sway and balance and may prevent falls (Cheniak, Florez & Troen, 2007).
10. What are specific examples used in facilities/agencies which implement universal design?
       Facilities/agencies can increase the assessment of frailty on their patients, and give patients a referral for an evaluation of frailty. This can decrease the morbidity and mortality rates associated with the functional decline in people. Stress to the patients who leave hospital care facility or professional homecare with a baseline or improved functional status. Encourage patients to use early utilization of rehabilitative services like occupational and physical therapy. There should be a support of institutional policy programs that would promote function,  like caregiver educational efforts and walking programs. There needs to be evidence of continued interdisciplinary assessments and evaluation of care on all of these patients (Benefield & Higbee, 2007). 
Tai chi might be beneficial for weakness, slow walking speed, and low physical
activity for individuals with frailty syndrome. By improving strength and balance,
it provides potential benefit for those with reduced ambulatory capacity or a tendency
to fall

References
Benefield, L. E., & Higbee, R.L. (2007). Frailty and its implication for care. Hartford Institute 
for Geriatric Nursing. Retrieved from http://consultgerirn.org/topics/frailty_and_its_implications_for_care_new/want_to_know_more
Cheniak, E. P., Forez, H. J., & Troen, B. R. (2007). Emerging therapies to treat frailty syndrome 
In the elderly. Alternative Medicine Review. Retrieved from http://findarticles.com/p/articles/mi_m0FDN/is_3_12/ai_n27421818/pg_7/?tag=content;col1 
Espinoza, S. E., & Fried, L. P. (2007). Risk factors for frailty in the older adult. John Hopkins 
Medicine. Retrieved from http://www.imsersomayores.csic.es/documentos/boletin/2007/numero-52/art-07-07-01.pdf