Frailty Wheel

1
Frailty Wheel

• Nicole Hill
• Kaiser Permanente Center for Health Research
• January 17, 2002

2
Overview

• Introduction and benefits
• Development
• Findings
• Administration

3
Introduction

• Screening tool for intake workers.

4
Introduction

• Frailty is defined as
• Persons with a high probability of dependency
  on others for daily care within the next 12
  months.

5
Introduction

• Why identifying the frail elderly is important
  for you
• At-risk individuals who need a further follow-up
  assessment
• Reduces the time needed to do a full assessment
  by accurately predicting those who may need help
  with their care
• Helps to screen those persons who may need more
  medical services against those who will utilize
  less services

6
Benefits

• Scientifically proven to predict frailty-91
  accurate
• Quick, easy
• Durable and small enough to carry around
• Time saving

7
Development

• 1985- The Center for Health Research began
  collecting data from their Social HMO members in
  the northwest region of Kaiser Permanente.
• 1992- They began a research project to develop
  the Frailty Model using 5,903 members of the KPNW
  Social HMO in 1990.
• 1996- A 45-question survey was completed called
  the Health Status Questionnaire.

8
Development

• 1997- SEEK, standing for Screen Every Elder in
  Kaiser was started, and the Health Status
  Questionnaire was adopted as the health screening
  form for all Kaiser members age 65 and up
  throughout the country.
• 2000- The Kaiser Permanente program asked for
  ways to simplify the screening process.
• 2001- Frailty Wheel was developed.

9
Development

• During the study
• Clinical classification of frailty was compared
  with the statistical data. The statistical
  method was able to correctly classify 24 more
  people than the clinical method which included
  assessment by a social worker.
• 10 of the population was classified as frail,
  and 90 was classified as non-frail.
• Based on these findings, the Research Center
  gathered utilization and mortality data from
  1990-1998.

10
Findings

• 1990-1998 Utilization(Days/person adjusted for
  attrition)

11
Findings

• Decade group mortality rates

12
Findings

• Survival rates, ages 80-84 years

13
Findings

• Survival rates, ages 85 years and older

14
Administration

• Aged-based categories.
• Questions relating to medication assistance,
  bathing assistance, and how their health
  conditions affect their every day lives.
• Detailed instructions provided on the wheel to
  guide interviewer (intake worker).

15
Administration

• Accuracy
• Demonstration
• Elizabeth- 77 years old, states that she does
  need assistance with her medications but does not
  need help with bathing and her health conditions
  do not interfere with her daily activities.
  Elizabeth is not frail.
• George, an 80 year old, states that he does need
  medication assistance, but does not need
  assistance with his bathing and his health
  conditions do not interfere with his daily
  activities. George is frail.

16
Administration
Age/Sex Specific Rates of FRAILTY within One
Year for Community-based Population
FEMALE MALE TOTAL AGE RATE () RATE () RATE ()