Frailty is a multidimensional geriatric syndrome characterised by a decline of physical and cognitive reserves that leads to increased vulnerability.

Frailty increases with age and is associated with falls, longer stays in hospital, difficulty recovering from illness and surgery, and mortality.

It is important to recognise frailty in older people in hospital so that we can develop and implement individualised care plans, reduce the risk of onset or deterioration and provide people with the opportunity to retain their independence and social connections on discharge.

This topic gives an overview of frailty and recommends actions that we and our organisations can take, in addition to health service policy and procedures, to provide quality care to older patients.

All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. While identifying and responding to issues of frailty are not directly referred to within the NSQHSS, this topic highlights the need to approach the clinical issues that older people face in hospital in a holistic and person-centred way in order to identify and respond to multiple modifiable risk factors throughout their stay. Doing this will improve our systems, clinical care and, ultimately, the outcomes for older people to prevent falls and harm from falls (standard 10), improve medication safety (standard 4), prevent and manage pressure injuries (standard 8) and identify and respond to cognitive impairment (delirium clinical care standard).

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