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What Is "Severe Frailty"?

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.

I know I was categorised into the top 2% of vulnerable patients at my GP surgery as part of a project the NHS were doing to try and be pro-active with patients with more chronic health needs. The aim was to keep them out of hospital. They no longer operate this but it benefitted me because it meant I had to have some kind of surgery intervention that day.
It’s alarming to see yourself described in this way (and I’m no old crock) but I’m realistic that my health needs probably are much greater than a high proportion of their patient list.
 
everydayupsanddowns said:
I agree about the complexity / unfamiliarity of the terms, but bolus just means “lump” doesn’t it? When you chew food, and your mouth forms it into a manageable blob that you can swallow, that blob is called a bolus as it passes down into your stomach (thanks pre-O-level biology!)

So for me the B and B terms are more trying to describe quick acting and long acting.

As to language generally, I couldn’t agree more. How many times have we shared experiences of the terrifying wording used in retinal screening letters? Or the blame and stigma that can be experienced by poorly chosen phrases.

The Language Matters work was great at highlighting how important this is, and how much impact it can have

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I agree: "quick acting" and "long acting" are probably precise enough for everyday use. It doesn't help that the words 'bolus' and 'basal' are so similar! I'm a big fan of plain English:

Plain English Campaign

Plain English Campaign is an independent group fighting for plain English in public communication. We oppose gobbledygook, jargon and legalese.
www.plainenglish.co.uk www.plainenglish.co.uk
 
everydayupsanddowns said:
When you chew food, and your mouth forms it into a manageable blob that you can swallow, that blob is called a bolus as it passes down into your stomach (thanks pre-O-level biology!)
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Maybe that was my problem - boluses didn't come up in History, Geography, Statistics, French, English Literature or any of my other O'levels :confused:
 
@CliffH - Percy Potter runs across the lawn every Monday evening, indeed. (he always used to do that every morning, until 'they' discovered Enterokinase, so me and a mate studying for our Biology O level in the 1960s changed it to being once a week!

I first encountered the term 'Geriatric Primagravida' yonks ago when my first husband had a GP's car in for some welding of the boot floor so opened the boot wherein was a cardboard box full of his copies of The Lancet that he hadn't yet got round to reading and I was bored so casually looked at the uppermost one in which there was an article about same and by then I understood both words, so when used together made no sense whatsoever, hence stunned to discover how very young the term G applied when we're talking about getting pregnant. My mom & dad were late starters since my dad did his War service serving in the RAPC in India whilst mom was at home in West Bromwich with her widowed mom. So 32 when she had my sis, 38 with me. Lack of opportunity rather than forethought!
 
trophywench said:
@CliffH - Percy Potter runs across the lawn every Monday evening, indeed. (he always used to do that every morning, until 'they' discovered Enterokinase, so me and a mate studying for our Biology O level in the 1960s changed it to being once a week!

I first encountered the term 'Geriatric Primagravida' yonks ago when my first husband had a GP's car in for some welding of the boot floor so opened the boot wherein was a cardboard box full of his copies of The Lancet that he hadn't yet got round to reading and I was bored so casually looked at the uppermost one in which there was an article about same and by then I understood both words, so when used together made no sense whatsoever, hence stunned to discover how very young the term G applied when we're talking about getting pregnant. My mom & dad were late starters since my dad did his War service serving in the RAPC in India whilst mom was at home in West Bromwich with her widowed mom. So 32 when she had my sis, 38 with me. Lack of opportunity rather than forethought!
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By the late 1970s it was 'Ptomaine poisoning rarely affects the little mouse's ears except in London'!

I worked in the Black Country (including West Brom) from 2004-17, when I lived in Wolves. I bet it's a bit different now to when your mom lived there.
 
Sounds far more useful than all I can recite from my O'Levels:

It was chrysanthemums when I married him and chrysanthemums when you were born. The first time they bought him home drunk, he had dead chrysanthemums in his button hole.
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DH Lawrence, Odour of Chrysanthemums.
 
helli said:
Sounds far more useful than all I can recite from my O'Levels:


DH Lawrence, Odour of Chrysanthemums.
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Well I never found a use for it! Being able to quote Lawrence is I think far more valuable in everyday life. It reminds me of Hugh Grant in 'Bridget Jones's Diary': "Season of Mists and Mellow Fruitlessness" :rofl:.
 
everydayupsanddowns said:
As to language generally, I couldn’t agree more. How many times have we shared experiences of the terrifying wording used in retinal screening letters? Or the blame and stigma that can be experienced by poorly chosen phrases.



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Water off a ducks back with me. I’ve heard some scary somber stuff since I was a child? Thanks for the link though. I’m taking a look. It also makes sense after first bite & “masticating” before swallowing (carful how you read it.) that “bolus” could be a common term for the dose of insulin administered to deal with this purpose prior to the meal. Certainly quicker to write than Novorapid. Though predictive text knows my habits on my bolus insulin. 🙂
 
Ah, well, I also remembered DW my Biology teacher demonstrating how to test something for dietary starch, ie carbohydrate, by setting up a retort stand over the sink in his bench, attaching a crust of bread (Mothers Pride, white thick sliced) into the clamp instead of a retort and dripping iodine onto it whereupon it very soon turned the most gorgeous Royal Purple colour - WOW! But of course aged 16 I never could have imagined how the knowledge that Ptyalin (aka 'Percy') secreted via the inside of the cheeks in the mouth started the bodily process of breaking down any carbohydrate eaten would actually be of any use whatsoever, but jolly good info to already know once you got Type 1 diabetes and were immediately started on insulin and thereafter needed to treat hypos.

See - it depends on your personal life experience what you find useful and what you don't.

(I also haven't found the opening words of that same Biology textbook stating that 'The earthworm is a cosmopolitan' of very much use, although the reason I've always remembered it is because I immediately thought Oh blimey, what on earth does the word cosmopolitan literally mean, then? - so even knowing the otherwise not useful fact in anyone ordinary's life, did help to educate me overall !)
 
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I went to bed early last night as I wanted to be awake early to follow the Las Vegas GP. Once in bed I started this post and fell asleep mid-post. When I woke for a comfort break I was so tired I just posted to save, had my break and went back to sleep.

I discussed this with two physiotherapists over the last few days. My regular one said she did not know much about the rating bar there was a bias towards mobility but "severe frailty" would not really describe me. On Friday I got a call from the community physio (this is outsourced to a different Trust) who would not agree to home physio when he visited a few months ago. He wanted to see how I was getting on but said he would probably discharge me after the next visit or phone call. He says he does these ratings and said they use the Rockwood Clinical Frailty Scale. This goes from 1 to 9 -

1: Very fit
2: Well
3: Managing well
4: Living with very mild frailty
5: Living with mild frailty
6: Living with moderate frailty
7: Living with severe frailty
8: Living with very severe frailty
9: Terminally ill or with a life expectancy of less than 6 months

He would put me in 7 (he does these ratings as he does home visits). as I am in a wheelchair and virtually housebound. If I got my licence back and could get out more I would be a 6! I find this odd in that I can transfer to a car but as anybody who becomes seriously ill or disabled swill find many (so called) friends just ghost you as you become to much bother! I then asked about other assumptions for these categories. In 7 it assumes you need assistance with personal care (he was unaware I did not have carers). At 6 it is assumed you need some help with personal care and dressing, and are unable to keep house (none apply)! Even at 5 it is assumed you need help with medication and meal preparation - again a no. I would accept a 4, Vulnerable, that means not dependent but activities limited.

Overall it seems an lout of date cack-handed grading system. Surely in this day and age they should come up with something better with a system that scores all areas with an algorithm to generate an appropriate grading instead of "uses a wheelchair" therefore "severely vulnerable". :(
 
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