About the Program
Background
Older adults with frailty are at risk of functional decline leading to further restrictions on community participation. Asia-Pacific Frailty Management Guideline suggests targeting the treatable risk factors and focusing on lifestyle redesign (Dent et al., 2017). Since community-based occupational therapy (OT) interventions have been shown effective in improving general health and well-being in older adults (Clark et al., 1997; 2012), this 12-week Say No To Frailty program was specially designed for community-living older adults with signs of frailty and pre-frailty. The program has been successfully piloted in the local community setting and participants with signs of frailty or pre-frailty demonstrated better physical functions and increased self-confidence in daily living activities and community participation.
About the programme
The Say No To Frailty programme led by a trained program leader/facilitator consists of 12 two-hour weekly group sessions that cover the following contents:
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Understanding frailty and risk assessment
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Understanding common chronic health conditions and causes
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Personalised goal setting
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Balance and strength exercises
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Fall prevention strategies
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Healthy eating
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Healthy lifestyle tips
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Strategies for community independent living
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Community mobility practice
The programme also includes a booster session and
phone calls during the post-intervention follow-up phase.
One family member or caregiver is welcome to join
the programme. The program outline is shown in Table 1.
Program Objectives
The Say No To Frailty program aims to facilitate older adults at risk to learn strategies in risk identification and self-management skills to regain confidence and independence in the community. By attending the program, participants will:
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understand the risk factors of frailty and workable preventative strategies suitable for individual participants.
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learn from each other how to be healthier with a stronger mind and body through small group discussion
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remain independent and improve safety in community living.
Who is suitable?
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Age 60 years old or above
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Able to communicate verbally and understand instructions
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Able to walk with/without a walking aid for a short distance independently
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Signs of frailty (e.g. muscle weakness, reduced balance and mobility, loss of weight) with Clinical Frailty Scale (CFS) scored between 4 and 6.
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No severe cognitive impairment (Abbreviated Mental Test score>5)*
*Clients with mild cognitive impairment are eligible to join this program; however, he/she must be
accompanied by a caregiver during the group sessions.
About the program facilitator
The program facilitator is someone who has a strong interest and vast experience working with
older adults living in the community. He or she should have extensive knowledge of frailty risk
identification and management and be able to facilitate every participant to learn effectively
through group discussion and from invited expert speakers. The program facilitator constantly
checks on the individual improvement through weekly homework, peer sharing and review of
personal goals. Both older adult participants and their family members or caregivers are
empowered to take charge of their own health and safety to achieve a better quality of life.
Any allied healthcare professionals (e.g. physiotherapists, occupational therapists, social workers, dietitians) or non-healthcare professionals (e.g. fitness instructors, exercise trainers, therapy assistants,
care coordinators, volunteers) who have completed the 2-day program facilitator training workshop can start the Say No To Frailty program in the community settings.
About the program leader
Any program facilitator who is a qualified allied health professional and has successfully completed a minimum of 2 programs and passes the fidelity & competency check in an additional one-day program leader training workshop conducted by the master trainer (Dr Tim Xu) will be qualified to become a program leader.
A program leader who is capable of running the program at his/her facility independently can provide
supervision and support to other program facilitators. The program leader is also expected to conduct fidelity checks with other program facilitators to ensure the quality of program delivery. He or she will be eligible to assist the master trainer in future program facilitator training workshops in Singapore.
Please email tim.xu@SingaporeTech.edu.sg to find out how to become a program facilitator/program leader.
Table 1. Say No To Frailty Program Outline
Say No To Frailty Program Facilitator Training Workshop (May 2022)
