Gerti WEWERKA, MSc
Chief Therapist, University Hospital Salzburg “Christian-Doppler-Klinik” – Geriatrics; Head of Geriatrics Network of Physio Austria (Federal Association of Physiotherapists of Austria)
In my opinion, frailty means that a person is physically weak, has lost weight, but especially muscle mass, and that daily activities become difficult as a result. Frailty is seen in older persons who face several challenges and illnesses and in the sum of all these difficulties are increasingly at risk of becoming dependent on support.
Because of loss of strength and endurance, activities outside the home become more difficult. Frail persons begin to avoid outdoor activities and are therefore less engaged in social activities.
Another challenge in advanced age is often, that persons have lost their partners or friends. This is a reason for a withdrawal from social activities. Cooking and eating alone is not funny and may result in malnutrition which contributes to weight and muscle loss.
When working with older persons as a physiotherapist, it is essential to be aware of a person’s frailty level, because it is important to treat frailty in the beginning: this is a stage, where muscles can be trained more easily to increase their mass and function than in advanced stages of frailty.
Challenging in treating persons with frailty is, that sometimes these people were never used to doing sports, so they just do not want to begin with physical training in their older age. The challenge is, to help them getting stronger, so they can leave their home again, and also help them to find something useful to do out of their homes.
The Austrian geriatric societies are aware of these challenges and it is considered in geriatric physiotherapeutic networks too. Frailty is a topic on national congresses and a lot of publications treat this issue. Probably persons who are not in medical professions do not know much or even anything about it?
I am impressed when I look at the website of the EU FrailSafe project by the ideas discussed there. The new technologies lead to possibilities I have not considered previously! When training older persons with mobility limitations, I use computer-assisted training programs, for example for balance training. People like it, because it is fun, even for the older ones among them. A lot of persons aged 65+ start using a smartphone. I have been in contact with patients aged 80+ and I have noticed that they are facing difficulties in the use of the “new phones”; they often say they do not like them.
I think that in the near future also very old people will be able to deal with the new technologies, because they have already grown up/old with them. I am very confident that they will benefit from computer-assisted training programs, technical assistance and diagnostic programs.