Frailty Identification

Pathway Publish Date: February 2024

Pathway Next Review Date: February 2026

Identification of Frailty

When to assess for frailty

Proactive identification/risk stratification i.e. eFI (electronic Frailty Index)
Predisposition to falls or changes in mobility
Delirium / acute confusional state / cognitive impairment
Poly-pharmacy (4+ medications), high susceptibility to medication side effects, and/or withdrawal from medication
Deteriorating functional score e.g. performance status - Barthel/ECOG/Karnofsky, or other changes such as change in continence
Anyone in a care home (including residential and nursing homes) or in receipt of a package of care
Anyone aged >75

Assessment for frailty

Confirm frailty status using Rockwood scale (see pathway)
Code into clinical system using code specified in the pathway/ on Ardens templates - not frail, mildly frail, moderately frail, severely frail (NB: the vast majority of severely frail patients will be in the last year of life, therefore, consider coding as end of life and discussing this with the patient.)
Screen for anxiety and depression using PHQ-2 and GAD-2 and code using code specified in the pathway/ on Ardens templates
Screen for loneliness using UCLA scale and code using code specified in the pathway/ on Ardens templates