GRANT. Katarina Wilhelmsson was the principal applicant for a project at Sahlgrenska Academy that recently received a large grant from the Swedish Research Council for Health, Working Life and Welfare (Forte). She is a member of the interdisciplinary FRESH research team at the Center for Aging and Health (AgeCap). The project deals with structured emergency care for the elderly.
What does this SEK 4.3 million mean to you?
“It’s a huge boon to our project. Not only do we have the resources to move forward, but it confirms that our research is sound, valuable and worthwhile. The opportunity to help elderly people and directly impact clinical practice is particularly rewarding. If everything goes well here in Gothenburg, we hope to expand to a multicenter study. A national steering committee that is serving as a coapplicant has assumed responsibility for implementing that vision.”
What exactly do you mean by fragility among the elderly?
“Fragility is a natural consequence of aging that affects all systems of the body. People find that they have less reserve capacity and resistance. As a result they are at greater risk of being dependent on others for their activities of daily living, as well as falls, illness and death However, fragility is partially reversible and the risks can be minimized if proper intervention begins early enough.”
You have said that all patients age 75 and older who receive urgent care will be screened for fragility. How will that be done?
“The screening process consists of four simple questions that a nurse asks at the emergency room: Do you get worn out after walking for 15-20 minutes? 2. Have you experienced general fatigue over the past three months? 3. Do you fall frequently or think that you are about to do so? 4. Do you need assistance to go shopping? Affirmative answers to two or more questions suggest fragility. The questions go quickly and are easy to ask. Our previous studies have demonstrated that they are highly valuable in clinical practice and that they provide good sensitivity and specificity for use in emergency room settings. They are based on the studies that we have already conducted about fragility among the elderly. All emergency rooms at Sahlgrenska University Hospital area are now following this screening process.”
Structured care of the elderly is based on the internationally renowned comprehensive geriatric assessment method. That multidimensional, patient-centered approach focuses on medical, psychological and functional capacity in order to draw up a coordinated, integrated plan for treatment and monitoring. The interdisciplinary teams consists of doctors, nurses, occupational therapists and physical therapists. A social worker and counsellor is frequently involved as well.
“Previous research has shown that the method improves functional ability, increases the chance of being able to live at home and reduces the risk of rehospitalization. The studies, however, are fairly outdated at this point and few have addressed contemporary emergency care. Because it is a randomized controlled study, we will be assigning patients to either an intervention group (at a ward that offers structured care) or a control group (at a ward that provides ordinary emergency services). The participants will be monitored for a year in order to identify any differences with respect to dependence on others for activities of daily living, physical and psychological function, general health, self-reported quality of life and healthcare consumption.”
Find out more about the grant at the Forte website.
