Evaluation and Management of Frailty

This chapter underscores the importance of interprofessional collaboration in the care of frail older patients. Hospital-based care is emphasized because interprofessionalism is difficult in that setting since the setting is constantly changing and since multiple healthcare professionals care for many complex, very ill patients, only some of whom are frail older people. Interprofessionalism is particularly important and challenging in teaching units in the acute care setting, where many health professionals practice and learn together and team membership changes frequently. Learning is enhanced and interprofessionalism can enhance learning by viewing the patient as a key part of the teaching team. While ‘best practice’ interventions have been identified for frail older adults who are hospitalized, these interventions are not easily implemented in routine hospital care. Three interdependent processes in clinical practice – representation, sense-making, and improvisation – are described, which contribute to an understanding of how practices change when implemented in a way that takes the local context into account and keeps person-centered care as the central consideration. © 2015 S. Karger AG, Basel Frail older adults are defined by their multiple, interacting medical and social problems. A range of skills is often required to meet their many complex needs and offer meaningful care. These skills typically are shared by many team members, where ‘team’ expertise evolves through the interdependent and collaborative work of multiple, interdependent disciplines. People in these disciplines need to be able to work together to achieve the best effect. Understandably, bringing together people with different points of view can be a challenge. Perhaps more surprisingly, the challenge is often glossed over. One context in which interprofessionalism and care of the frail older perFrailty and Interprofessional Collaboration Marion C.E. Briggs a, d · Janet E. McElhaney b, c a Northern Ontario School of Medicine and b Health Sciences North and c Advanced Medical Research Institute of Canada, Sudbury, and d AMS Phoenix Project, Toronto, Ont., Canada D ow nl oa de d by : K el lo gg H ea lth S ci en ce s Li br . 19 8. 14 3. 38 .6 5 10 /2 0/ 20 15 3 :4 1: 58 P M