This paper discusses engaging older adults living with frailty and their family caregivers. Frailty is a state that puts an individual at a higher risk for poor health outcomes and death. Understanding whether a person is frail is important because treatment and health care choices for someone living with frailty may be different from someone who is not (i.e., who is fit). In this review, the authors discuss strategies and hurdles for engaging older adults living with frailty across three settings: research, health and social care, and policy. The authors developed this review using published literature, expert opinion, and stakeholder input (including citizens). Engaging frail older individuals will be challenging because of their vulnerable health state - but it can be done.

Wendy Duggleby from the University of Alberta and Barbara Pesut from the University of British Columbia described an innovative way to assist older adults to age in place by providing navigation services where a knowledgeable individual advocates, facilitates community connections, coordinates access to services and resources, and promotes active engagement of frail older adults with their community during this webinar presentation.

France Legare of the Universite Laval presented about a training program that teaches doctors and interprofessional teams how to share decisions with their frail elderly patients about tough decisions such as whether to stay at home or move to a care facility. 

Michelle Kho of McMaster University presented about their clinical trial.  In‐bed cycling uses special equipment that attaches to a patient’s hospital bed, allowing them gentle leg exercise while in the ICU. The main goal of this research program is to see if patients who need a breathing machine recover faster if they receive early in-bed cycling than those who do not.  

This systematic literature review and narrative synthesis from the UK aimed to investigae the attitudes of the public and healthcare professionals to Advance Care Planning discussions with frail and older people.

The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons.  This study differs from previous studies in that it focuses on ADL and IADL disability and used a relatively short follow-up period.

In this review the authors describe the epidemiology, mechanisms, detection and management of drug-induced liver injury with particular concern to old age. They argue that monitoring for clinical response is essential to optimize efficacy and reduce toxicity. They warn that the detection of adverse effects of medications in older patients can be complicated by nonspecific presentation as geriatric syndromes.

The 2010 clinical practice guideline for the diagnosis and management of osteoporosis in Canada focused on the care of adults living in the community. However, the fracture rate for adults living in long-term care (residents) is two to four times that of adults of similar age living in the community, and one third of older adults who experience hip fracture are residents in long-term care. 

Katherine McGilton, Toronto Rehabilitation Institute and Martine Puts, University of Toronto, reviewed interventions that are designed to prevent and/or treat frailty in community-dwelling older adults and reviewed international policies that have been developed to this end.