User-friendly guides for the most common health and functional issues faced by older people in care
Comprehensive geriatric assessment is the cornerstone of caring for older people. There are many tools to assess the needs of older people, such as the interRAI assessment system used in home care and aged residential aged care in New Zealand. However, it is difficult to translate assessment data into useful interventions that encourage resilience and adaptation to increasing frailty as one ages.
In 2008 the Waitemata DHB Residential Aged Care Integration Programme worked with aged care providers and nurses to co-create user-friendly guides for the most common health and functional issues faced by older people in their care. The resulting RN Care Guides include 18 evidence-based guides for the most common gerontology concerns.
It has become obvious in recent years that this type of guide would be useful for the care of frail older people across all health care settings. So, in 2018 the Commission has collaborated with aged residential care providers to use the RN Care Guide development process and template to create the Frailty Care Guides. The guides aim to enhance care planning and form the basis of future quality improvement initiatives in aged care.
The Frailty Care Guides include the following topics. Those containing a hyperlink are now available for testing:
|1||Defining and recognising frailty|
|4||Last days of life|
|5||Advanced care planning|
|6||Enduring power of attorney|
|9||Deprescribing and polypharmacy|
|10||Congestive heart failure|
|11||Constipation and gastro-intestinal|
|13||Dementia and behaviours that challenge|
|17||Fractures and contractures|
|18||Nutrition and hydration|
|22||Syncope and collapse|
|23||Sexuality and intimacy|
|25||Urinary tract infection|
You can download a document listing the relevant abbreviations and references here.
We have now published 23 of the 27 draft guides on this page (see links above) and invite residential age care providers and other relevant stakeholders across New Zealand to review and test them, and provide feedback using this online survey. Feedback will remain open up to and following upload of the final drafts. The final close-off date will be announced in the Commission's e-digest. If you have not already signed up to receive the e-digest, please click here. Alternatively, please check this web page.
The final versions of the guides will be completed in 2019.
Dr Michal Boyd is leading the Frailty Care Guide project and is working on the preliminary draft in collaboration with the Waitemata DHB Residential Aged Care Integration Programme workgroup led by Janet Parker, gerontology nurse practitioner. This group was responsible for the original 2008 RN Care Guides that form the basis for the new Frailty Care Guides.
Dr Boyd is also working with a sub-group of aged care clinical experts to develop tools to recognise acute and gradual deterioration frail older people. This group includes:
Louise Fowler, gerontology nurse practitioner – Bay of Plenty DHB
Christy Jackson – palliative care nurse specialist/project manager – Bay of Plenty DHB
Julie Daltrey, gerontology nurse practitioner – Waikato DHB
Tina Chivers, manager, Seadrome Home and Hospital
Maree Ellin, clinical manager, Highgrove Village and Patrick Ferry House