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On this page you'll find tools to help you explore and measure what matters for older people with frailty.

What matters to people living with frailty?

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Older people living with frailty are often concerned with more than just their physical health needs. The things that matter most to them include:

- quality of life

- maintaining their strengths and relationships

- being involved in conversations about their current and future care [1]

Despite this, care services are often oriented toward addressing individuals’ physical health needs. Outcome measures are often designed around how to measure the quality of physical care [2].

How can we ensure we are capturing, measuring, and addressing what matters most to older people living with frailty?

Person-centred approaches

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Patient reported outcome measures (PROMs) and Patient reported experience measures (PREMs) are examples of person-centred tools, which can capture a person’s experiences and look at outcomes from the point of view of the person experiencing them [3].

This means they prioritise what is important to the person receiving care.

PROMs and PREMs are increasingly used in service evaluations and can help clinicians identify and act upon unmet need [4].

Tools for measuring outcomes & experience

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Tools to measure outcomes for end of life care have been predominately developed to meet the needs of those with cancer and other single life limiting diseases. It is still unclear how well these tools address the expressed needs of people with frailty.

There are a range of tools available that could help to measure outcomes for this group. You will need to consider carefully how appropriate each tool is, depending on your objectives.

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Tools developed for palliative care populations

Person-centred approaches

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Other person-centred approaches to capturing outcomes and experiences of those with frailty: 

Service markers

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You should also consider which service markers and metrics can be used to reflect whether individuals’ preferences for care are being met. These include:

Preferred place of care (PPoC) provides a reflection of whether individuals’ preferences are being heard and acted upon. This should not be considered synonymous with Preferred Place of Death (PPoD).

Unplanned hospital admissions, 30-day re-admissions and emergency visits are routinely collected to measure care across a setting. Such metrics have been shown to increase for older adults with frailty in the last year of life.

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Reviewed by colleagues in the Living and Dying Well Research Group, University of Surrey

This content was produced in collaboration with the Living and Dying Well Research Group at the University of Surrey.

The information on this page was adapted from text written by Faith Howard, PhD Student for the PRO: Frail Study.

References

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