Frailty is a multidimensional geriatric syndrome characterised by a decline of physical and cognitive reserves that leads to increased vulnerability.
Frailty increases with age and is associated with falls, longer stays in hospital, difficulty recovering from illness and surgery, and mortality.
It is important to recognise frailty in older people in hospital so that we can develop and implement individualised care plans, reduce the risk of onset or deterioration and provide people with the opportunity to retain their independence and social connections on discharge.
This topic gives an overview of frailty and recommends actions that we and our organisations can take, in addition to health service policy and procedures, to provide quality care to older patients.
Frailty and ageing
Frailty is characterised by a decline in body functions and systems. A frail person may have difficulty recovering from illness or surgery or coping with minor illness and events.
Screening and assessing frailty should consider a person’s physical performance, nutritional status, cognition and mental health.
Responding to frailty
Frailty is a complex problem that requires multiple interventions targeting physical performance, nutritional status, mental health and cognition.
Frailty and discharge planning
Discharge planning and communication at transition from hospital is vital to address frailty.
Further information - frailty
Educational and information resources available on frailty in older people in hospital.
All public and private hospitals are required to be accredited to the Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. The primary aims of the standards are to protect the public from harm and to improve the quality of health service provision. Assessment to the second edition of the NSQHS Standards commenced in January 2019. The second edition comprises eight standards that provide a nationally consistent statement about the level of care consumers can expect from health services.
The Comprehensive Care Standard (Standard 5) aims to ensure that patients receive comprehensive health care that meets their individual needs, and considers the impact of their health issues on their life and wellbeing. It also aims to ensure that risks of harm for patients during health care are prevented and managed through targeted strategies. These include integrating patient care processes to identify patient needs and identifying actions related to falls, pressure injuries, nutrition, mental health, cognitive impairment and end-of-life care.
Information is presented in the Older People in Hospital learning topics that complements Standard 5 and other NSQHS Standards including the; Partnering with Consumers Standard (Standard 2), Medication Safety Standard (Standard 4), Communicating for Safety Standard (Standard 6) and Recognising and Responding to Acute Deterioration (Standard 8).
Reviewed 10 November 2021