What is frailty?

Frailty describes a person’s mental and physical resilience. That is, their ability to recover from events like illness or injury.

In practice being frail means a relatively ‘minor’ health problem, such as a urinary tract infection or a fall, can have a severe long-term impact on someone’s health and wellbeing.

It may affect their health, independence, and ability to return to previous levels of activity.

Long term conditions

Frailty is not the same as living with long-term health conditions. While there is often some overlap, a person can be frail without having any diagnosed medical conditions.

Frailty is usually linked with:

• Reduced muscle strength
• Fatigue
• Slower movement
• Increased vulnerability to illness or injury

Around 10% of people over the age of 65 live with frailty. This increases to 25–50% of people aged over 85.

This chart shows that people with more severe frailty have less reserve to cope with illness or injury.

This means their recovery is slower, less complete, and they are at higher risk of long-term dependence or negative outcomes.

Clinical Frailty Scale (CFS)

While you’re on the rehabilitation ward, you may be screened for frailty using the Clinical Frailty Score (CFS).

This score helps us better understand your needs and work with you to create a personalised care and support plan.

These plans focus on your own goals and preferences and help us deliver care that matters to you.

We also work with you and your family to help:

• Maintain your health at home
• Reduce the risk of being in hospital longer than necessary

Being in hospital can increase the risk of decline for older people living with frailty.  That’s why we focus on supporting you to recover safely and confidently at home wherever possible.

More information on the CFS can be found at www.england.nhs.uk/ourwork/clinical-policy/older-people/frailty/living-with-frailty/

Living with frailty

If you’re living with frailty, you might notice changes such as:

• Feeling slower or more tired than usual
• Muscle weakness
• Needing more help with daily activities like washing or dressing
• Unplanned weight loss
• Taking longer to recover from illness
• Finding it harder to make complex decisions

Living with frailty can mean having to adapt your routines and find new ways to manage everyday life. Family members and carers often adjust too, to support these changes.

How we can help

We as the multi-disciplinary team (Nurses, Medics, OT and PT) will complete a comprehensive assessment and work with you to support your wellbeing and independence. This may include:

• Reviewing your health and any medications to make sure they are still right for you. Minimising side effects and avoiding unnecessary treatments.
• Undertaking a falls assessment if appropriate. Put in place a strength training programme.
• Assess your cognition if appropriate
• Talking with you about what matters most in your life
• Supporting you to plan ahead, including making choices about future care if you become more unwell. This is known as advanced care planning.

Help reduce or delay frailty

There are things you can do to help stay well and independent:

• While you are on the ward, use all opportunities to actively participate in your rehabilitation, progress maybe gradual but every effort makes a difference.
• Be physically active every day, if you can. Activities can include gardening, dancing, walking, swimming.
• Stay socially connected: talk to friends or join local groups
• Stop smoking
• Limit how much alcohol you drink
• Eat a healthy, balanced diet
• Maintain a healthy weight