Frailty and Aging: How the Danish Experience Might Inform Canada

Muscedere, John; Barrie, Carol; Chan, Karen C.; Cooper, Bruce A.; Critchley, Kim; Kim, Perry; Lorbergs, Amanda L.; Mackenzie, Isobel; Martineau, Cynthia; Noseworthy, Tom; O'Neil, Maureen; Resin, Joyce; Sinha, Samir K.; Williams, Russell

doi:10.12927/hcq.2019.25841

Cited by 5 publications

(5 citation statements)

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“…The predicted growth in the proportion of older Canadians, combined with the current shortfall in delivery of health care for this older cohort, requires greater attention to the provision of health-related programs, policies, and services for older adults in general, and for older frail adults in particular. ( 16 ) Understanding older adults’ health-care needs and goals has important implications for a wide array of health-care fields. The complexity of health-care requirements for frail patients requires collaboration among health-care professionals, and the integration of an array of health-care practices to effectively respond to patients’ health-care needs and goals.…”

Section: Discussionmentioning

confidence: 99%

Using Comprehensive Geriatric Assessment in Identifying Care Goals and Referral Services in a Frailty Intervention Clinic

Aggarwal,

Brar,

Goodstadt

et al. 2023

Can Geriatr J

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The proportion of older adults and frail adults in Canada is expected to rise significantly in upcoming years. Currently, a considerable number of older adults do not actively participate in developing their own care plans; prior research has indicated several benefits of patient engagement in this process. Thus, we conducted a mixed methods study that examined the prevalence of rehabilitation goals and identified these for 305 community dwelling older adults referred to a frailty intervention clinic utilizing Comprehensive Geriatric Assessment (CGA) between 2014 and 2018. Top patient concerns included mobility (84%), services, systems, and policies (51%), sensory functions and pain (50%), and self-care or domestic life (47%). The most common referrals or recommendations for patients included further follow-up with a physician or specialist (36%), referral to an onsite falls prevention clinic (31%), and medication modifications (31%). Based upon these findings, we recommend greater utilization of CGA within a team-based approach to improve patient care by allowing for greater collaboration and shared decision-making by health-care providers. Moreover, CGA can be an effective tool to meet the complex and unique health-care needs of frail patients while incorporating patient goals. This is vitally important considering the predicted growth in the population of frail and/or older patients, as well as the current challenges and shortfalls in meeting the health-care needs of this population.

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Section: Discussionmentioning

confidence: 99%

Using Comprehensive Geriatric Assessment in Identifying Care Goals and Referral Services in a Frailty Intervention Clinic

Aggarwal,

Brar,

Goodstadt

et al. 2023

Can Geriatr J

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“…Another feature of successful integrated care models for older persons with frailty is the consistent and large-scale support from regional, provincial and national governments [11,19,41,45,46]. Interestingly, researchers from countries with highly developed primary care programs have reported difficulties observing effects in their intervention groups.…”

Section: Discussionmentioning

confidence: 99%

The Seniors’ Community Hub: An Integrated Model of Care for the Identification and Management of Frailty in Primary Care

et al. 2021

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(1) Background: Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors’ Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot. (2) Methods: SCH was piloted in an academic clinic with six family physicians. Eligible patients were community dwelling, 65 years of age and older, and considered to be at risk of frailty (eFI > 0.12). Health professionals within the clinic received training in geriatrics and interprofessional teamwork to form the SCH team working with family physicians, patients and caregivers. The SCH intervention consisted of a team-based multi-domain assessment with person-centered care planning and follow-up. Patient-oriented outcomes (EQ-5D-5L and EQ-VAS) and 4-metre gait speed were measured at initial visit and 12 months later. (3) Results: 88 patients were enrolled in the pilot from April 2016–December 2018. No statistically significant differences in EQ-5D-5L/VAS or the 4-metre gait speed were detected in 38 patients completing the 12-month assessment. (4) Conclusions: Future larger scale studies of longer duration are needed to demonstrate impacts of integrated models of primary care on patient-oriented outcomes for older adults living with frailty.

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“…Prioritization of foodservice in health care as medicine has been identified as a lesson for Canada to learn from Denmark [27]. This has resulted in positive changes in foodservice practices as demonstrated by a Danish study [28] comparing practice from 1995 to 2003.…”

Section: Discussionmentioning

confidence: 99%

Canadian Hospital Food Service Practices to Prevent Malnutrition

Sorensen

FletcherRD²,

MacdonaldMAdEd

et al. 2021

Canadian Journal of Dietetic Practice and Research

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Purpose: The study aimed to determine current practice, barriers, and enablers of foodservices in Canadian hospitals relative to guiding principles for best practice to prevent malnutrition. Methods: Foodservice managers completed a 55-item cross-sectional, online survey (closed- and open-ended questions). Results: Survey responses (n = 286) were from diverse hospitals in all Canadian regions; 56% acute care; 13% had foodservices contracted out; and 60% had a reporting structure combined with clinical nutrition. Predominantly, foodservice systems were 43% in-house versus 41% pre-prepared, 46% cook–serve food production, 64% meals assembled centrally (on-site), and 40% non-selective menus with limited opportunities for patient choice in advance or at meals. The “regular menu” (44%) was most commonly served as 3 meals, no snacks at specific times. Energy and protein-dense menus were available, but not widespread (9%). Daily energy targets ranged from 1200 to 2400 kcal and 32% of respondents viewed protein targets as important. The number of therapeutic diets varied from 2 to 150. Conclusions: Although hospital foodservice practices vary across Canada, the survey results demonstrate gaps in national evidence-based practices and an opportunity to formalize guiding principles. This work highlights the need for standards to improve practice through patient-centered, foodservice practices focused on addressing malnutrition.

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Frailty and Aging: How the Danish Experience Might Inform Canada

Cited by 5 publications

References 0 publications

Using Comprehensive Geriatric Assessment in Identifying Care Goals and Referral Services in a Frailty Intervention Clinic

Using Comprehensive Geriatric Assessment in Identifying Care Goals and Referral Services in a Frailty Intervention Clinic

The Seniors’ Community Hub: An Integrated Model of Care for the Identification and Management of Frailty in Primary Care

Canadian Hospital Food Service Practices to Prevent Malnutrition

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