Extending Frailty Care Programme
Find resources and information to support hospices to deliver frailty attuned models of care.
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What's on this page
What is frailty?
Frailty is a distinctive state of health that is related to the ageing process, in which multiple body systems gradually lose their in-built reserves [1].
People living with frailty often have additional multiple health problems including cognitive decline.
How does frailty affect older adults?
Living with frailty is different from living with one life-limiting disease. The trajectory towards end of life is more uncertain and typically includes episodes of acute illness and periods of full or partial recovery.
Frailty is a cause of death in older people [2], [3], which means those with frailty are likely to form a significant proportion of people with palliative care need. People with frailty have a range of needs that are responsive to palliative care interventions, but studies reveal they are less likely to receive palliative care than people with advanced cancer [4]. People with frailty are often underserved at end of life [5].
Hospices are uniquely placed to enable older people with advancing frailty to have a better quality of life, by responding to individuals’ needs and working creatively and holistically to deliver and support care.
Find out more by watching a recording of our conference session about frailty care.
Extending Frailty Care programme
Our Extending Frailty Care programme invites hospices to think differently and creatively to support high quality care for older people with frailty at end of life. It runs from April 2022 to March 2025.
Programme overview
Watch Cat Sullivan, Senior Clinical and Quality Improvement Lead, Hospice UK, give an overview of the programme (this video was taken from a presentation to our Expert Reference Group, in phase 1 of the programme).
Click or tap the image to play the video.
Funded projects
As part of the Extending Frailty Care programme, we are funding 11 hospices to develop and deliver innovative models of frailty care. These models demonstrate and share effective ways of caring for, and working with, people aged over 65 who have advancing frailty.
The successful grant projects have now been confirmed. Find out more about their projects.
Project ECHO
All our grant funded projects will be participating in a Project ECHO Network, to share learning and support each other. We will be disseminating this learning regularly.
Evaluation
We have also employed external evaluators to help us assess the impact of the programme. Find out more about our external evaluation.
Resources
Using the learning from the first phase of our Extending Frailty Care programme, we have developed some resources to support hospices deliver frailty attuned care.
Please contact Melanie Hodson, Head of Information Support, if you would like information about the literature reviews behind the programme.
Opportunities for improvement
Watch Anita Hayes, Head of Clinical Leadership, Hospice UK, outline the opportunities for improvement in frailty care (this video was taken from a presentation to our Expert Reference Group, in phase 1 of the programme).
Click or tap the image to play the video.
Useful sources of information
The following organisations provide information about frailty care that you might find helpful. The content and views expressed by these organisations do not represent the views of Hospice UK.
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Resources on supporting people with frailty and urgent care needs to get home from hospital.
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Resource to support clinicians and others to provide high quality care for frail older people as they move towards the end of their lives.
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The Centre for Ageing Better provides a range of useful resources, including a set of downloadable infographics about living longer and a report looking at the state of ageing in 2022.
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Healthcare Improvement Scotland's Frailty care planning and coordination are a set of tools and resources to help you consider how best to deliver care to people living with frailty.
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NHS England resources on issues that are common in frailty, such as falls, immobility, delirium, incontinence and side effects of medication.
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Resources from the Northern Ireland Frailty Network, including education modules, exercise videos and monthly newsletters.
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Resource published by St Christopher’s Hospice, looking at how hospices can make their services accessible, appropriate and effective for people with frailty needs.
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Watch the University of Surrey’s educational film, which shows 10 older people with severe frailty and four of their friends and family members, discussing what is most important to them in living their lives well.
Access to the film requires registering contacting information for the purpose of tracking the impact the film is having.
Carrying out research
Read our tips and guidance on carrying out robust research and development projects.
We would like to acknowledge the generous support provided by the Kirby Laing Foundation towards the Extending Frailty Care programme, without which the programme would not be possible.
This content was produced in collaboration with the Living and Dying Well Research Group at the University of Surrey.
References
1. Clegg, A. et al. Frailty in elderly people. The Lancet. 2013; 381(9868):752-62.9
2. Peng, Y., Zhong, GC., Zhou, X. et al. Frailty and risks of all-cause and cause-specific death in community-dwelling adults: a systematic review and meta-analysis. BMC Geriatrics 2022; 22(725).
3. A statement from the BGS: British Geriatrics Society. End of Life Care in Frailty: Identification and prognostication. [internet] 2020 [cited 20 Feb 2023]
4. Hamaker, M.E., van den Bos, F. and Rostoft, S. Frailty and Palliative Care. BMJ Supportive and Palliative Care 2020; 10:262-264
5. Stow D, Spiers G, Matthews FE, Hanratty B. What is the evidence that people with frailty have needs for palliative care at the end of life? A systematic review and narrative synthesis. Palliative Medicine. 2019;33(4):399-414. doi:10.1177/0269216319828650
Image: courtesy of In-Press Photography via The Centre for Ageing Better