What it is: Frailty describes a condition which includes unintentional weight loss, self-reported exhaustion, slow gait, weakness and low physical activity.
Why it matters: The risk of frailty increases as people age and is most common in people aged over 80 years, and in people with multiple illnesses and disability. This includes people with a life-limiting illness.
Frailty affects a person’s function, resilience, and ability to recover from an episode of ill health. It often indicates that they are approaching death and palliative care may be appropriate. Nurses can plan care with the person and their family.
What I need to know: It is important to identify when a person with a life-limiting illness is frail or is at risk of becoming frail, as their outcomes are poorer with minor illnesses such as infections.
The last year of life is generally characterised by a steady decline in overall function and increasing frailty, rather than a sudden decline in any one aspect of health. This can mean that carers and health professionals may not recognise that death is approaching and that palliative care needs should be assessed.
For people with a life-limiting illness the trajectory will depend on their underlying condition(s).
Screening and assessment for frailty should look at a person’s:
- physical performance
- nutritional status
- cognition
- mental health
- support that they may receive from family, the community, their social connections
- financial situation.
Use a validated tool to assess frailty, this will help to identify any needed changes and provide evidence for the impact of any changes made.
Frailty and dementia together predict a more rapid decline and shorter life expectancy.