Frailty Assessment and Guided Geriatric Coaching
Frailty Management is a geriatric consultation service, provided by Dr.Min Keun Song, MD, MPH, CMD, HMDC, CPE, geriatric specialist. We provide patients with their frailty index score based on the cumulative deficit model of frailty. We calculate the frailty index from routinely collected items of a comprehensive geriatric assessment. Based on the frailty index, we propose guided geriatric coaching to educate the patients and their families and to empower self management of their conditions . For the patients with high frailty index, we coordinate proper interventions and treatments to prevent poor health outcomes.
Min Keun Song, MD, MPH, CMD, LLC
Information on Frailty
What Is Frailty
Frailty is a chronic progressive condition caused by physiologic decline which increases vulnerability to adverse health outcomes such as falls, delirium, hospitalization, nursing home placement and death. As people age, health deficits accumulate and is eventually manifested as frailty.
Why The Frailty Matters?
A common health issue in older adults, a study estimated that about 50-75% of adults aged 85 and older are frail. Old and frail adults are more likely to have delayed recovery from illness, to develop greater functional impairment and to die than non-frail old adults.
Because of loss of physiologic reserve, frail adults are highly likely to develop sudden health status changes triggered even by a minor stressor such as medication change. Certain medical treatments and procedures could be harmful to them.
Most importantly, frailty is a slippery slope, and it can quickly spiral out of control. Therefore, it is very important that frailty is identified at early stage so that healthcare professionals focus on proper management to prevent further decline.
How Do We Assess The Frailty?
Out of many proposed methods to measure frailty, one of the best ways to quantify frailty is the frailty index, a ratio of a person’s health deficits over the number of health deficits assessed. This proportion ranges from “0”, meaning “very robust” or “very fit” to “1”, meaning “extremely frail”. However, the quantitative ratio can be categorized into discrete categories such as “not frail”, “frail”, “severely frail”. Generally, a frailty index of 0.25 or higher indicates that the person is frail, and a frailty index higher than 0.45, is considered to be severely frail. Typically people cannot tolerate frailty index higher than 0.7.
Guided Geriatric Coaching
After assessment, we generate a frailty index report, which shows a person’s frailty index score, highlighted summary on the health deficits, estimated biological age as well as suggested action plans.
This information will not only deepen a person’s insight on his/her health issues but will also empower self-management of the conditions and promote healthier lifestyle. (Guided geriatric coaching)
There is another benefit from repeating frailty assessment in regular basis. This can generate long term frailty index data, which can be used for personal health progress evaluation and prediction of morbidity and mortality.
Our frailty index data can also provide better risk discrimination and inform clinicians of their patient’s vulnerability and need for additional perioperative management, which leads to reduction of post-surgical complications.
Personalized Geriatric Care
Geriatricians are the experts in aging related complexity and managing multiple health issues effectively.
Dr.Min Keun Song is an expert in frailty as he has been working with very frail elderly patients in the community, nursing homes as well as hospice setting. He uses frailty assessment data for patient-centered care intervention, preoperative risk assessment and setting up a goal of care. He also refers patients to geriatric case management service for multidisciplinary interventions.
Dr.Song's clinic is located at Beth Israel Deaconess Hospital in Milton (100 Highland Street, Suite 105, Milton, MA 02186).
The office phone number : 617-696-7600
Assessment & Management
Affiliation/Professional Society
Frailty Assessment
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Medical history assessment
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Functional status assessment
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Performance tests in cognition, muscle strength and gait speed
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Nutritional assessment, BMI measurement
After assessment, we create the frailty index score report which shows frailty index, highlighted summary on their health deficits , estimated biological age and suggested action plans.
Guided Geriatric Coaching
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Reviewing the frailty index score report with customers for better understanding and implementation of suggested interventions
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Coaching on specific action plans for better self management
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For a customer's choice, assisting the use of activity tracking system such as smart watch to improve activity level and sleep quality.
About Dr.Min Keun Song, MD, MPH, CMD, HMDC, CPE
Dr.Song is a board certified internist and geriatrician. He graduated from Seoul National University School of Medicine and received geriatric fellowship training at Beth Israel Deaconess Medical Center/Harvard Medical School. He also holds a master degree from Harvard Chan School of Public Health, focused on family and community health.
He is a member of Harvard Medical Faculty Physicians as well as Gerontology Division of Beth Israel Deaconess Medical Center. Currently he serves Beth Israel Deaconess Hospital in Milton as Geriatric Medical Director. He also serves long term care facilities and a hospice program as certified medical director.
He is a Certified Physician Executive(CPE) leading and influencing health care and a geriatric entrepreneur inventing innovative geriatric care solution by using wearable devices/sensors available at current market.
Dr.Song’s mission is to provide high quality of senior care in community and nursing homes by focusing on patient-centered care, quality of life, teamwork and communication with families.
