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When to look for frailty

Any interaction between an older person and a health or social care professional should include an assessment which helps to identify if the individual has frailty.

This includes (but is not limited to) the following:

  • Routine outpatient appointments in all departments, including surgical (orthopaedic, GI, vascular and ophthalmic departments), medical and mental health (memory clinics). 
  • Social services assessment for care and support.
  • Review by the community care teams after referral for community intervention.
  • Primary care review of older people (either medical intervention or medicines review or any other interaction such as one of the long term conditions clinics).
  • Home carers in the community.
  • Ambulance crews when called out after a fall or other urgent matter.

It is self-evident that the type of assessment will differ when dealing with an individual who is currently unwell (and therefore a short screening assessment may be of limited benefit) instead of being in a stable situation. Professional discretion will need to drive the nature of the assessment. However planning any intervention (e.g. starting a new drug, conveying to the emergency department or an elective joint replacement) in an individual who has frailty, without recognising the presence of the condition and balancing the risks and benefits, may result in significant harm to the patient.

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