Clinical Frailty Scale

Scoring frailty in people with dementia: The degree of frailty corresponds to the degree of dementia.
Common symptoms in mild dementia include forgetting the details of a recent event, though still remembering the event itself, repeating the same question/story and social withdrawal.
In moderate dementia, recent memory is very impaired, even though they seemingly can remember their past life events well. They can do personal care with prompting.
In severe dementia, they cannot do personal care without help.

1) Very fit: People who are robust, active, energetic and motivated. These people commonly exercise regularly. They are among the fittest for their age.
2) Well: People who have no active disease symptoms but are less fit than category 1. Often, they exercise or are very active occasionally, e.g. seasonally.
3) Managing Well: People whose medical problems are well controlled, but are not regularly active beyond routine walking.
4) Vulnerable: While not dependent on others for daily help, often symptoms limit activities. A common complaint is being “slowed up” and/or being tired during the day.
5) Mildly Frail: These people often have more evident slowing, and need help in high order IADLs (finance, transportation, heavy, housework, medication). Typically, mild frailty progressively impairs shopping and walking outside alone, meal preparation and housework.
6) Moderately Frail: People need help with all outside activities and with keeping house. Inside, they often have problems with stairs and need help with bathing and might need minimal assistance (cuing, standby) with dressing.
7) Severely Frail: Completely dependent for personal care, from whatever cause (physical or cognitive) Even so, they seem stable and not at high risk of dying (within 6 months).
8) Very Severely Frail: Completely dependent, approaching the end of life. Typically, they could not recover even from minor illness.
9) Terminally Ill: Approaching the end of life. This category applies to people with a life expectancy <6months, who are not otherwise evidently frail.

Your Care – Palliative Care Approach – Long Term Care

Some residents are transferred to Emergency Rooms in acute care hospitals during an unanticipated crisis in their final stages of life. This can cause unnecessary suffering and distress and the care that a resident receives may not reflect their needs, values and preferences for care and treatment in their last phase of life. An example of suffering our residents may experience in the Emergency Room, is Delirium, a sudden onset of confusion due to the change in environment and staff, bright lights, excessive noise, unfamiliar medication administration, etc.

A ‘Palliative Approach’ is described as a person-centered approach to care guided by the understanding that the person is on a progressive life-limiting illness trajectory. Communication related to the resident and their family’s evolving understanding, personal preferences, and goals of care is understood as essential. Therefore, a palliative approach acknowledges the likelihood of gradual transition, emphasizing quality of life considerations during the active treatment phase. It recognizes that treatment goals will evolve from seeking a cure, to control of disease and complications, maintaining physical comfort and quality of life, and ultimately to symptom control.

Evidence shows that persons who receive a palliative approach suffer less, are physically capable for longer; are better able to interact with others for longer, may survive 25% longer, and family members are less likely to experience depression after their loved one has died.

How does Menno Place incorporate the Palliative Approach in Providing Care?

Conversations begin during move-in, as to what the understanding of the current condition/disease process and how it might change over time. At care conferences, discussion occurs with families/residents to determine what the goals of care are, based on the “frailty scale” and what the resident would/could have preferred as treatment while their condition declines. Ongoing conversations occur between families and/or residents and the entire team (Chaplains, Nursing, Recreation, Social Workers, etc.) as their condition declines, regarding goals of care. Ultimately, the goal is to provide quality comfort and palliative care at Menno Place.

Palliative Care at Menno Place is excellent, supported by the entire team. Chaplains and their volunteers visit and remain vigil if this is what the families/resident prefer. The nursing team provides excellent care to ensure comfort remains the priority for you at this time.

Donations – Long Term Care

Menno Place does not accept the donation of resident’s personal items. This includes clothing, furniture, recliners and paintings / wall art. There are rare occasions when an item may benefit another resident or the care home.

If you feel the item you wish to donate fits in this category, please contact the Life Enrichment Coordinator to discuss this possibility.

Menno Place staff are not permitted to accept gifts of cash or material possessions from residents or family. If you wish to express your appreciation, please consider an item that can be shared among the staff, such as a box of chocolates, a card or a bouquet of flowers.

Menno Place gratefully accepts financial donations towards campus-improvements as well as donations towards the purchase of a Memorial Bench. Click here for more information .

Moving Out of Long Term Care

When people move in to Menno Place Long Term Care, we understand that this may be their last home. When a residents time here changes, either through a transfer/discharge to another care provider or by death, the resident’s belongings must be claimed and removed within two (2) days (including day of death). The balance of the rent will be refunded less any outstanding trust charges. This process could take up to 45 days from discharge.

Personal Furnishings – Long Term Care

At Menno Place, we ask that you only bring in a few pieces of furniture, as space and storage are limited, and to ensure a safe environment.

Closets are equipped with shelves which provide an area to keep clothing.

Some rooms may only accommodate one chair, such as a recliner.

Other rooms may accommodate a small chair, small dresser/desk or side table, along with your television.

A washable comforter, pictures and photos from home all help give your new home a more personal touch.

Please speak to a member of your Care Team before bringing additional furniture.

We cannot assume responsibility for loss, damage, cleaning of upholstery or repair of any personal belongings.

We suggest you label all items.

Due to limited space, the amount of furniture, equipment or personal belongings in a room may need to be reduced if there is overcrowding.

Staff must be able (when necessary) to safely use a portable lift or other equipment to assist a resident. They will advise you if/when the removal of items becomes necessary for safety reasons.

Menno Place does not accept the donation of personal furnishings. Which includes furniture, recliners and paintings / wall art. There are rare occasions when an item may benefit another resident or the care home.

If you feel the item you wish to donate fits in this category, please contact the Life Enrichment Coordinator to discuss this possibility.