We all live on a biological continuum that runs from fitness to frailty. As we accumulate chronic conditions and these impact function and/or cognition we are moving away from being fit to being frail. Although frailty is more often associated with aging, one can actually be frail at any age if disability accumulates from any trauma, condition, or genetic disorder that impacts function and/or cognition.

A frail person represents a complex system at the edge of failure.” (Rockwood, 2009)

The frail person is at an increased risk for adverse outcomes and sudden declines after even a minor illness or stress. Some short-stay nursing home patients are frail and this impacts their rehab and recovery potential. All long-stay patients are frail and as their degree of frailty increases so too does their risk for unwanted outcomes such as weight loss, falls, hip fractures, or skin breakdown.

Identifying the presence and degree of frailty present prior to or at the time of admission allows facility professionals to develop plans to mitigate and document risk before the outcomes occur and to manage and document unavoidable outcomes when they occur. Even with the best nursing care patients with a high degree of frailty are at risk and deserving of your proactive approaches to their care. Your risk-based documentation will contribute to PDPM accuracy and inform the DOH survey process.


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)