Pilot implementation of the mod-REFS frailty screening tool in an Australian home care provider to improve client health and well-being

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Frailty, characterized by vulnerability and reduced resilience, significantly impacts older adults, increasing adverse health risks.
• Early identification of frailty is crucial for preventing further health deterioration in the aging population.
• A holistic screening tool is needed to optimize health and well-being for individuals receiving aged and community home care.

Purpose of the Study:

• To implement and evaluate the modified Reported Edmonton Frail Scale (mod-REFS) as a holistic frailty screening tool.
• To assess the feasibility, acceptability, and fidelity of the mod-REFS within an Australian home care setting.
• To identify prefrail and frail individuals to enable timely interventions.

Main Methods:

• The Implementation Framework for Aged Care guided the co-designed implementation and evaluation process.
• Home care staff, including nurses, allied health, and personal care workers, administered the mod-REFS.
• Feasibility, acceptability, and fidelity were evaluated using administrative data and a staff survey.

Main Results:

• The mod-REFS was completed for 218 clients, with 65% identified as prefrail or frail.
• A higher prevalence of prefrail and frail individuals was noted in Victoria compared to Queensland.
• Most staff found the mod-REFS helpful, practical, and easy to use, with 85% requiring no training.

Conclusions:

• The mod-REFS is a feasible and acceptable tool for identifying prefrailty and frailty when used by diverse home care staff.
• Successful implementation necessitates stakeholder input and collaboration.
• Early identification and intervention using the mod-REFS can prevent deterioration and enhance the well-being of home care recipients.