There are many tools available to measure frailty and to generate a Frailty Risk Score. Some have international validation and have been used in research or at the bedside for decades. An internet search will generate a long list of options that would require some time spent reviewing them in order to find the best fit for PALTC settings.

We have done that evaluation and selected a tool that analyzes routinely collected MDS data to calculate a Frailty Risk Score, a measure of vulnerability to adverse outcomes, and to generate a Comprehensive Geriatric Assessment with recommendations for a proactive approach to care as a way of mitigating the risk and avoiding negative outcomes where possible.

The Frailty Risk Score is a valid measurement of a patient’s physiological age predicting the risk for rehospitalization, length of stay, potential for recovery and return to baseline. The score is also useful for determining the most appropriate discharge setting for the patient – PAC, LTC, Palliative Care, Home, etc. As the score increases so too does the risk of the unwanted clinical outcomes such as wounds, falls, delirium, death,

The Frailty Risk Score is also beneficial for 1) Framing difficult and necessary conversations, 2) Supporting patient-centered decision making, and 3) Empowering patients and families in making informed decisions on the basis of risk and benefits of each care option.

 

Knowing the frailty status is better than age to determine if a patient is likely to benefit from a treatment or be harmed  (Theou, Rockwood, 2012)

 

As frailty increases, potential for recovery decreases (Theou, Rockwood, 2012)