Keeping Up to Date with Frailty Related Issues

This is the last post in the Frailty Matters Coaching and Teaching programme which you have all been participating in. Frailty and the care of people with frailty, like all areas of health and social care is an area constantly being researched and best guidance on care as a result changes. It is important therefore to keep up to date with what is going on in Frailty care and management so that you and your team continue to deliver the best care possible. So this post is going to offer a few tips for keeping up to date.

The first resource to mention is one that we have used already within the programme, which is the British Geriatric Society Frailty Hub https://www.bgs.org.uk/resources/resource-series/frailty-hub The Hub was created in June 2020 and will be the place where the BGS will hold its national guidelines and best practice relevant to frailty. The BGS also have their own Journal Age and Ageing and on their website they host a collection of articles from the Journal that looks at Frailty in older people. You can access their collection at https://www.bgs.org.uk/resources/age-and-ageing-collection-frailty-in-older-people

The Royal College of Nursing (RCN) also host a a page on frailty where you will find advice and resources on identifying frailty in older patients and choosing the right interventions to help manage their condition. See: https://www.rcn.org.uk/clinical-topics/older-people/frailty

They also have a larger frailty resource held on their magazine website called the RCNi frailty resource collection. https://rcni.com/features/frailty-resource-collection-84906 This is not open access however, you need to be subscriber to one of the RCNi Magazines listed here. https://rcni.com/journals to get access to their online materials.

NHS England has two specialist groups that deal with frailty issues. They are the Acute Frailty Network. Their ‘Guidance and Resources’ pages in particular are useful and worth keeping track of. https://www.acutefrailtynetwork.org.uk/

There is also the NHS Specialised Clinical Frailty Network. on this site you will find a range of tools and resources to support the improvement of NHS specialised services for older people living with frailty.

On the Royal College of GP’s website there is a toolkit that provides a collection of relevant tools and information to assist primary care teams to implement a six-step model of collaborative care and support planning which is very useful for supporting the care a number of patients groups including adults living with frailty. See: https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/collaborative-care-and-support-planning-toolkit.aspx

It is also worth noting that Health Education England, NHS England and Skills for Health provides a single, consistent and comprehensive framework that sets out the skills, knowledge and behaviours expected of any person who is involved in the care and support for people living with frailty. https://www.skillsforhealth.org.uk/images/projects/frailty/Frailty%20framework.pdf?s=form which may prove useful when you are considering your own development and that of the members of your team.

Finally it is worth occasionally using the following terms in Google from time to time just to see what is produced by the Cochrane Library Database of Reviews. They don’t have a specific frailty collection yet but they do very frequently review topics of interest to health and social care professionals looking after people living with with frailty. Search Using “Cochrane Library Frailty” in Google and see what comes up.

Looking After Yourself and Your Team during COVID-19

This may be the last Blogging piece for a while but the project and this Blog will resume in due course. In the meantime we thought we should leave you with some resources that you and your team can turn to and try out in the coming weeks as this unprecedented, once in a hundred years, health crisis continues.

The first thing that we would like to share is some timely advice from the Queen’s Nursing Institute, Scotland (QNIS) from Hilda Campbell, Chief Executive of COPE Scotland and QNIS Honorary Fellow has provided the following wee ideas of things that could help you look after yourself and create some ‘me time’. Even if it is just a few minutes. You can access Blog here

It also includes other links within it which are worth following up. It would also be a good idea to share this resource with all the staff that you are working with.

The next resource we are going to suggest is from the Kings Fund and it looks at compassionate leadership in this time of crisis. it discusses the idea of an ABC of compassion at work, suggesting that leaders need to help provide Autonomy and Control, a sense of Belonging and a promote feelings of Competence. working in a compassionate way will aid in supporting your whole team through this stressful time. For more about this see: https://www.kingsfund.org.uk/blog/2020/03/covid-19-crisis-compassionate-leadership

On a similar theme this is a paper recently published in the BMJ by Greenberg N., Docherty M., Gnanapragasam S., Simon W. (2020)  Managing mental health challenges faced by healthcare workers during covid-19 pandemic BMJ; 368 :m1211 You can access it here.

https://www.bmj.com/content/368/bmj.m1211

The paper looks at measures that healthcare managers need to put in place to protect the mental health of healthcare staff having to make morally challenging decisions. Its brief and well worth reading particularly about aftercare; what needs to happen once this crisis passes.

Currently NHS staff are also being granted free access to a number of mental health apps to support their health and wellbeing as they work around-the-clock to treat coronavirus patients.

The apps, which include platforms to proactively improve mental health as well as sleep improvement programmes, will be freely available until December 2020.They include Unmind, a platform that provides a range of tools to help with stress, sleep, connection and nutrition; Headspace, a mindfulness and meditation app aimed at reducing stress and building resilience; Big Health’s Sleepio, a clinically-evaluated sleep improvement programme, and Daylight, a cognitive behavioural technique to manage worry and anxiety. You can access them all via this page of the NHS Employers website https://www.nhsemployers.org/news/2020/03/free-access-to-wellbeing-apps-for-all-nhs-staff

The final resource and perhaps the most important is to be found on the Scottish Association for Mental Health (SAMH) website. They have collected together all the resources that can help and protect everyone’s’ mental health and wellbeing as they cope with the stresses brought about this pandemic and the stresses caused by of social isolation. We would urge to make use of this site and please share it with all your staff and patients 

https://www.samh.org.uk/about-mental-health/self-help-and-wellbeing/coronavirus-and-your-mental-wellbeing

That’s all for now folks and we hope to see you all safe and well when things start to get back to normal.

Coaching and Education-Session 1

The day started with introductions and establishing the ground rules for each session. Working in groups is like one to one clinical work, establishing good relationships and trust are the fundamentals of working well and moving learning and action, so focus is placed on “checking in” and setting the ways of working together.

A short film from Age UK on frailty was shown and then a discussion took place about what the film had brought up, what was recognisable and what was new. The group then split into pairs to do an exercise exploring our own experience of frailty. This had a two fold purpose, one to help us to understand our own experience and how these relate to learning and the second aspect of the exercise was to continually listen and not speak whist the other person was telling their story. Listening is an essential skill in coaching development. Although we spend our lives listening, how much do we truly listen; do we listen to hear or listen to respond? The focus here was on really listening and not talking in response, just encouraging. Each person took 10 minutes doing this. The group then discussed how this exercise made them feel and why it was important to listen. What people shared was that it was harder than they imagined to just listen and not interject with their own story or give advice. They also noticed how good it was to be really listened to questioning how often does that happen? Audrey suggested that if all they took away was how to really listen this will have made a difference to everyone.

We then went on to do an exercise in pairs discussing what matters to you rather than asking what’s wrong with you. Audrey shared the video on Don Berwick discussing where the campaign came from and the important shift in care and support that happens when we approach a therapeutic relationship with “what matters to you”. The exercise helped people experience that for themselves and start to look at how that will be different for each individual.

At the end of lunch the group participated in a mindfulness session. Audrey explained that offering mindfulness was about helping people develop tools for resilience which help everyone involved in the care relationship. Also mindfulness is not a relaxation technique but rather an awareness skill which the group will build on over the sessions but the sessions will be entirely voluntary to take part in.

In the afternoon the Frailty Matters Blog was introduced and since you are on it to read this you should know its at: http://frailtymatters.uws.uk

All the information on frailty covered in the programme will posted on this Blog. A new post will be made every fortnight for the duration of this phase of this project. You are encouraged to revisit the Blog and comment on any aspect of it. Suggestions for improvements, more information etc. are welcome this resource is designed to help you with all aspects of the programme.

Each participant was given a notebook for reflection to be used in whatever way is comfortable to them. This is each participants reflective book and participants won’t be asked to share it.

Each person was given a have a postcard that you have completed about what you would like to get out of these sessions. People in the main want to learn about frailty and how to work with it. Participants gave feedback at the end of the session and were asked to reflect on  what they would like covered in these sessions. Prevention was mentioned as important and the group was asked to bring further suggestions to the next session.   

Welcome

Thank you for agreeing to take part in our research study. As you are aware the research is being carried out by the University of the West of Scotland,  The Health and Social Care ALLIANCE ( the ALLIANCE) and NHS Ayrshire and Arran. It is funded by the Burdett Trust for Nursing.

The study aims to increase your skills in managing frailty in the community. We plan to create, deliver and evaluate a person-centred intervention with two components: a coaching programme and an educational intervention on effective and personalised care and support for people living with frailty in the community. To find out more CLICK HERE

Throughout the programme you will be able to provide feedback based on your experience of this training and how it is helping you to support other members of your team in managing frail older people. Your views may help other people affected by frailty in the future by helping the research team to understand what are the key issues in the management of  frailty in the community so that we can help others to identify the best ways to address them.

This Blog is going to act as your teaching resource and will be here for you throughout the study. The plan is to place all the teaching resources used in the sessions on this site and also to post additional information and useful materials we find while the project is running. Note that anything that you see on this site that is BLUE is a link to a useful resource.