Dementia is a sub-set of Frailty targets for general hospitals and must be taken into account.

People living with dementia are more likely than people the same age to have other conditions in addition to dementia. This could mean that they do not recover as quickly as they are less reliant when they become acutely unwell. If a person with dementia is admitted to hospital due to an illness or accident their frailty* should be assessed and considered when delivering care.

*NHS England describes frailty as a loss of resilience that means people don't bounce back quickly after a physical or mental illness, an accident or other stressful event.

For extra information, evidence and best practice please scroll down to the bottom of the page.

Regional offerings

Dementia Wellbeing Plan for Greater Manchester; Dementia United

The Greater Manchester dementia wellbeing plan promotes personalised planning conversations with people living with dementia and carers about their needs and wants. The plan ensures an improved standard of care planning for people living with dementia and also facilitates sharing across the system. It will be available as a standardised plan which can be accessed and shared digitally between practitioners; as well as being available from the website for people affected by dementia to be using when having person centred care plan reviews
Weblink: https://dementia-united.org.uk/dementia-wellbeing-plan/

Evidence

Lancet Commission 2020: "Compared to the general older population, people with dementia have increased rates of cerebrovascular disease, stroke, Parkinson’s disease, diabetes, skin ulcers, anxiety and depression, pneumonia, incontinence, and electrolyte disturbance. Multimorbidity in people with dementia is associated with faster functional decline and worse quality of life for people with dementia and their family carers."

NICE, Improving care and support for people with frailty How NICE resources can support local priorities: "People with frailty are at risk of falls. They're also at risk of developing conditions such as anxiety and depression, and are more likely to have unplanned hospital admissions. Identifying people with frailty and improving their care and support are therefore priorities for the health and care system."

Royal College of Psychiatrists, Frailty, Ensuring the best outcomes for frail older people: "The prevalence of frailty in clinical settings reaches 60% for older people attending acute wards. To assess and manage frailty requires an interdisciplinary approach that encompasses functional, psychological and medical input and includes long-term planning within our complex and changing healthcare systems. "

Best Practice Resources

Fit for frailty, British Geriatrics Society: Not all older people are frail and frailty is not an inevitable part of ageing. But around 10 per cent of people aged over 65 years have frailty, rising to between a quarter and a half of those aged over 85, and they are at risk of adverse outcomes such as dramatic changes in their physical and mental wellbeing after even minor events. There is a risk of significant harm to them if health interventions are planned without recognising their frailty. The British Geriatrics Society believes that all those working with older people should be aware of, and assess for, frailty. With this in mind we have developed guidance on the recognition and management of older patients with frailty in community and outpatient settings. Called 'Fit for Frailty', it has been produced in association with the Royal College of General Practitioners (RCGP) and Age UK. The purpose of these guides is to advise about action which can be taken to prevent these adverse outcomes and help people live as well as possible with frailty

NHS RightCare: Frailty Toolkit Optimising a frailty system: This NHS RightCare system toolkit will support systems to understand the priorities in frailty care and key actions to take. It provides a way to assess and benchmark current systems to find opportunities for improvement. It is produced with reference to an expert group of stakeholders and is supported by NICE. Wider consultation has taken place with patient representatives, clinicians, social care organisations, professional bodies and other key stakeholders.

SDEC_guide_frailty: Looking for frailty must become an embedded part of the acute assessment of people aged over 65 Preventing ward moves AND Environmental adaptations should include:

non-glare lighting
access to visual and hearing aids and large print signage and information
non-slip flooring and handrails, wherever possible
a calm environment with reduced background noise
staff trained and geriatric medicine champions appointed to promote gold standard care
Maintained/improved scores during stay AND identify the potential for medication-related harm, which is several fold more likely in patients with frailty.