Understand Frailty - Another Part of Aging

We experience changes in our health and bodies as we get older. Some people become frail. Frailty is not a normal part of aging but has tremendous consequences including higher risk of needing long-term care.
Updated: May 20th, 2021
Linda Kople

Contributor

Linda Kople

Back in the 70s, when I was in high school, people in their 40s and 50s looked old. Today many people don't act or feel old well into their 70s and beyond. However, others age faster and look and act old.

None of us will escape the fact that we get older each and every day. We notice it, although most of us ignore it or are in denial of our aging process. 

If we are honest with ourselves, we know the changes we have experienced. You can see it in the face, our overall body, and body functions. We all start having some health problems. We often dismiss it by saying, "it's only a little high blood pressure, but I'm on the lowest dose". "My sugar is up a little, but it is not diabetes; it is pre-diabetes, nothing to be concerned about." "I've gained some weight, but who hasn't been stuck in COVID isolation for so long."

Life Includes Aging

We are experiencing life. Whether we have faced significant health problems or accidents or have been lucky so far, we are all hoping for a healthy and happy retirement once we start that journey. We understand the risks of aging. There are many types of dementia that we could suffer from at some point when we are older. There are strokes, complications due to diabetes, and heart failure. The list goes on and on.

One aging problem that has not received as much attention is frailty. According to John Hopkins University, an estimated 7 to 12 percent of Americans aged 65 and older are considered frail. The risk of frailty increases as we get older —from one in 25 people between ages 65 and 74 to one in four of those older than age 84. 

Frailty is a concern as it increases our risk of getting infections and illnesses that require hospitalization. It even increases the already bigger risk of falls and physical disabilities.

Frailty Increases Long-Term Care Risk

Frailty doubles the risk of surgical complications. It also extends hospital stays and increases the odds of becoming dependent on others, including moving into an assisted living facility or nursing home following a surgical procedure by as much as twentyfold.

Samuel Durso, M.D.

"If we understand the underlying biomedical processes that create frailty, we can develop better interventions—from medications to lifestyle changes," says Samuel Durso, M.D., director of geriatric medicine and gerontology at Johns Hopkins. 

Generally, being frail is characterized by a person's diminished strength, endurance, and physiologic function. This frailty increases a person's risk of becoming more dependent and requiring long-term health care.  

Activity is Helpful

But Dr. Durso says some lifestyle steps can help limit the frailness that comes from aging. 

"One cause of frailty is the age-related loss of muscle mass," Durso explains. 

Durso says that current research recommends activities like walking and easy strength-training moves can improve a person's strength and reduce weakness – even in very old, frail adults. 

Delaying the need for long-term health care will improve the overall quality of life. Even if an older person needs in-home care or care in a facility, less frailty will still improve their general level of independence and this better quality of life. 

Identifying Frailty 

According to John Hopkins, your loved one is considered frail if they meet three or more of the following criteria: 

  • The person is getting smaller. The person is shrinking and unintentionally lost ten or more pounds in the past year.
  • Exhaustion. The person is unable to get going three or more days in most weeks.
  • Weakness. The person has trouble standing without someone's assistance, or they have reduced grip strength.
  • Low activity level. The person lacks formal exercise, but they also fail to do everyday chores and activities that they used to do without a problem, including fun activities they used to enjoy.
  • Slow pace. If the person is walking very slow and takes more than six or seven seconds to walk 15 feet, this would be an unusually slow pace.

Positive Attitude is Beneficial 

Some research has shown being positive lowers the risk of frailty. One way to stay positive is social interaction, which has become more difficult during the height of the COVID-19 virus crisis. However, as more people get vaccinated, some of the problems of isolation will be alleviated.

"Staying socially connected with others and continuing to learn may also help. Johns Hopkins research has found that those factors may explain why older volunteers who tutor in elementary schools sharpen their own thinking skills and improve their physical functioning too," Durso says. 

Falls – Huge Concern for All Older Adults

One of the big problems with frailty is a concern for all older adults. This concern is the risk of falls. Falls are a leading reason older adult go to the emergency room and end up needing long-term health care services and supports. 

The American Geriatrics Society recommends an annual fall risk assessment for individuals aged 65 and older. While critical for all older adults, if a family member is frail, the risk of a fall increases. 

All this talk about getting older and the consequences of aging should remind us that preparation will make our aging experience easier for everyone in the family. 

Have a Discussion About Aging

A discussion of our retirement plans and how we address the costs and burdens that come with getting older is a talk that should happen soon than later. Most people express the desire not to be dependent on their children when they get older—none of us what to be a burden. Yet, what steps have we taken to avoid that result?

For many people, Long-Term Care Insurance is a way to ensure that there are resources available to provide quality care and give the family the time to be family. The guaranteed tax-free benefits give you the power of choice and control. You cannot prevent aging and changing health, but you can make sure the consequences are easier on yourself and your family.

Experts say the best time to obtain coverage is when you are younger, ideally in your 40s or 50s. Whenever you purchase a policy, it will be your reasonably good health when you apply for coverage that will determine if you get a policy in the first place. 

Premiums vary over 100% between insurance companies, so be sure to shop with a Long-Term Care Insurance specialist that works with the major companies. You can find a trusted and qualified specialist by clicking here.

Long-Term Care Costs Vary Depending on Location and Level of Care

LTC Insurance is custom designed. The specialist should review the current and future cost of long-term health care where you live or where you plan to relocate. The LTC NEWS Cost of Care Calculator is a great tool to use for this purpose. 

For your parents or other older family members where it is already too late to plan, you can find quality caregivers and facilities where you live. If they want to remain in their homes, be sure you check for fall risks and other safety hazards. Medical alert systems can be beneficial to maintain a level of safety and independence in a person's home. 

Reverse mortgages in some situations can provide income and resources to help, either to fund a Long-Term Care policy or to provide money for in-home care. The LTC NEWS section on reverse mortgages can be helpful - click here

In some cases, it might be safer for a loved one to move into assisted living. There is a higher level of independence in assisted living with access to care as needed. Plus, social activities keep both the mind and body active. 

Be proactive with both yourself and your future planning and for your older family members. Try to avoid a crisis since crisis planning is never a good thing for anyone.

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