A1 · Frailty
Actual Older adult
Definition
General weakness, low energy, and slow recovery that raise the chance of falls and illness.- Aging
- poor nutrition
- inactivity
- chronic disease
- low reserves
- Weakness
- slowness
- tiredness
- weight loss
- falls
📋 Scenario
An older woman has a slow walk, exhaustion, and unintended weight loss.
Subjective (S): "I'm weak and tired all the time."
Objective (O): Slow walk; lost 5 kg; weak grip; one fall in 6 months.
Assessment tools for this scenario: CP-OLDER Older Adult Check CP-SAFE Safety & Falls Score CP-FLUID Fluid Balance & Nutrition Score
Validated scales to consider: 4AT / CAM, Mini-Cog, Morse Fall Scale, MUST, fluid chart, glucose
**CarePath diagnosis:** Frailty related to aging, as evidenced by weakness and slowness.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Assess strength and nutrition. | Measuring grip, walking speed and weight and reviewing food intake shows how frail she is and which causes can be treated, so the plan fits her needs. |
| Start an exercise program. | Regular, gentle exercise rebuilds muscle strength and balance, which improves walking speed and lowers the chance of falling. |
| Prevent falls. | Weak muscles and slow walking raise fall risk, and a fall can cause fractures and loss of independence, so safe surroundings and aids matter. |
| Review medicines. | Some medicines cause dizziness, drowsiness or poor appetite, so a review can find and reduce those that add to weakness or falls. |
| Involve the team. | Dietitians, physiotherapists and doctors each address a different cause of frailty, so a team approach gives more complete care. |
**Expected outcomes**
- Gains strength.
- No falls.
- Walking speed improves in 4-8 weeks.
- Nutrition improves.
**Linking the data to the diagnosis**
The patient says, 'I'm weak and tired all the time.' The nurse finds a slow walk, a weak grip, a 5 kg weight loss and one fall in 6 months. Together these show ongoing low reserves, so this is an actual problem and not a risk of falls alone, and it is also more than a single fall or one tired spell. Frailty is the best fit because weakness, slowness and weight loss occur together. The plan aims to build strength, prevent further falls, improve walking speed over 4 to 8 weeks and improve nutrition.
CarePath diagnosis
Frailty related to aging, as evidenced by weakness and slowness.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Assess strength and nutrition. | Measuring grip, walking speed and weight and reviewing food intake shows how frail she is and which causes can be treated, so the plan fits her needs. |
| 2. Start an exercise program. | Regular, gentle exercise rebuilds muscle strength and balance, which improves walking speed and lowers the chance of falling. |
| 3. Prevent falls. | Weak muscles and slow walking raise fall risk, and a fall can cause fractures and loss of independence, so safe surroundings and aids matter. |
| 4. Review medicines. | Some medicines cause dizziness, drowsiness or poor appetite, so a review can find and reduce those that add to weakness or falls. |
| 5. Involve the team. | Dietitians, physiotherapists and doctors each address a different cause of frailty, so a team approach gives more complete care. |
Expected outcomes
- Gains strength.
- No falls.
- Walking speed improves in 4-8 weeks.
- Nutrition improves.
Linking the data to the diagnosis
The patient says, 'I'm weak and tired all the time.' The nurse finds a slow walk, a weak grip, a 5 kg weight loss and one fall in 6 months. Together these show ongoing low reserves, so this is an actual problem and not a risk of falls alone, and it is also more than a single fall or one tired spell. Frailty is the best fit because weakness, slowness and weight loss occur together. The plan aims to build strength, prevent further falls, improve walking speed over 4 to 8 weeks and improve nutrition.