Frailty
“In emergency departments, ‘older people have endured particularly long waits. The average waits for people over the age of 65 have nearly doubled over the past 15 years from just over three hours to nearly seven.” Darzi review
How can we help these older and often frail patients? Hint: we can educate ourselves about frailty just
We launched the BMJ Best Practice Comorbidities Manager with ten comorbidities. People really liked it and thought that the comorbidities we had included were just about right. But lots of people told us there was something missing. And that thing was frailty. So we added it in.
Now you can use the BMJ Best Practice Comorbidities Manager to find out how to manage patients with common combinations of conditions plus frailty. Lots of these patients are the ones waiting for hours in emergency departments - and so they really need any help we can give.
Here are some things about frailty that many healthcare professionals miss out on. • Frailty is often associated with ageing, but it’s not an inevitable part of ageing. Young people can be frail too. • Cognitive frailty means physical frailty and cognitive decline. • You should not give up on frail patients. Physiotherapy, nutrition, and addressing social determinants of health can make a difference. • Frail patients are often on multiple medications. And they are prone to adverse effects of multiple medications. • There is an association between chronic low-grade inflammation and frailty. • People worry about having a heart attack or getting cancer. But frailty is often just as serious. Despite all of this, frailty is underdiagnosed. And undertreated. And not taken into account when making treatment decisions. If you want to do better, have a look at BMJ Best Practice. Go to “acute exacerbation of COPD”. Add frailty. You will find guidance on assessing frailty, ceilings of intervention,
and resus status. On coming to shared decisions. This is just one combination - there are many more.
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