Integrated care for older adults living with frailty

Abstract

Provision of health and social care to our ageing population is one of the biggest challenges faced by health care systems today. Older adults living with frailty have complex care needs secondary to multimorbidity, polypharmacy, physical dysfunction as well as social and psychological factors. Consequently, they are often subject to disjointed and fragmented care that carries a high predisposition to lower treatment and care plan adherence as well as more adverse drug reactions. The main principle for delivering effective integrated care is through a patient-centred approach, with improved co-ordination amongst health care professionals. By minimising variation in the approach to care delivery, patient care and experience can improve. Favourable outcomes from integrated care models depends on the application of multicomponent strategies with vertical and horizontal integration of objectives identified by shared decision making and Comprehensive Geriatric Assessment. In this brief review, we describe frailty; the methods used for screening and discuss successful models of integrated care.