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As of 2024, approximately 137 million people worldwide are aged 80 years or older. This number is projected to increase in the coming decades, reaching approximately 265 million by the mid-2030s and 426 million by 2050. Medical frailty is likely if someone lives long enough. In this article, Nancy Poland offers ideas on how to care for someone who has become medically frail. She also encourages us to recognize this coming phenomenon and be prepared.

With grace and hope, Nancy R Poland provides written and spoken communication on caregiving, loss, and other valuable topics. She has authored two books on caregiving, issues a newsletter, and offers both in-person and virtual presentations. Visit Nancy’s website for more information.

Surprisingly Frail

The pain center told us, “Your mom has a ‘crumbling spine.’ No surgery will help; the best we can do is give her steroid shots. Older people with chronic pain conditions are approved to receive these shots more often.”

Mom had other medical issues, including cancer. Her weight decreased; she looked like a feather might blow her over. Mom was medically frail.

Do you have a parent or other care partner (someone for whom you have become a caregiver) in their 80s or 90s? If so, look — they could become frail, and safety is a significant concern. Younger individuals with new or existing disabilities can also fall into this category.

What is Medically Frail?

Medically frail describes individuals whose health is severely compromised. They have chronic health conditions, which can include heart disease, cancer, diabetes, or severe osteoporosis, causing their bones to be thin and brittle. It can also include cognitive impairments such as dementia.

Medicaid and other Coverage

Medicaid is a government program wherein people who medically qualify, and with financial need, receive health insurance at little or no charge. People on Medicaid who qualify as medically frail may be placed in Alternative Benefit Plans (ABPs), which provide more services than standard Medicaid.

Medicare, which is available to anyone 65 and older, has standardized benefit coverage. Private insurance has varying rules and benefit designs. The Children’s Health Insurance Program (CHIP) has its own coverage rules that are distinct from those of ABPs.

If your care partner lives in a nursing home, the level of care can be determined by the person’s frailty. They likely need close monitoring, medication management, and assistance with activities of daily living. This status can determine the level of care they are allowed.

Home Care

What if your loved one is medically frail and living at home? Safety is of the utmost importance. What can be done?

• Recognize that falls are a major risk for the elderly or disabled. Walk through their house to identify fall risks. The National Alliance for Caregiving, in collaboration with the National Council on Aging, provides the Falls Prevention Conversation Guide for Caregivers. Take time to download this easy-to-read guide containing a checklist, a discussion guide with a place to take notes, and practical ideas.
• Medication Safety – certain medications, or a combination of meds, can cause dizziness or other reactions. Become involved in your care partner’s medication management.
• Bathrooms are a scene of frequent falls.
  • I slipped and fell on the wet bathroom floor several weeks ago! As a result, we replaced the multiple rugs with one long rug.
  • Grab bars in the bathroom are helpful, but beware of ones that adhere with suction cups, which can easily unstick. Consider professionally modifying the bathtub or shower, although this is costly.
  • Try a raised toilet seat with arms or a bedside commode.
• Lighting – place automatic nightlights around the house. Evaluate where lighting can be improved.
• Obtain a wearable medical alert system for your care partner.

Make a Plan

Your loved one may get to the point where they cannot live alone or with another medically frail adult. Initially, hiring home health aides can help. However, it is important to make a plan before a crisis ensues.

• Make certain you have legal documents in place, including power of attorney for fiduciary issues, a home health care directive with a healthcare agent and alternative named, and a will. Consult an elder care attorney for the best advice. You will need these documents to make decisions about your care partner.
• Tour facilities such as assisted living or nursing homes before they are needed. This will give you and your care partner ideas about what is available and affordable.
• Due to limited funds, I knew my dad-with-dementia would eventually need a facility that accepted Medicaid. Understand their financial situation; if limited funds are available, it is easier to make one move to a place that accepts Medicaid rather than make multiple moves.
• If they are resistant to moving, find help. Sometimes, a third party can present a case for a change. Our realtor collaborated with a resistant Dad to sell the house, as Mom needed a safer environment.

Conclusion

If we live long enough, medically frailty is likely in our future. Plan ahead! Start early to avoid a caregiving or personal crisis.

Visit my website, www.gracesmessage.com, for more caregiving tips.