Assessment instruments for frail elders: a literature review.

Abstract

The frail patient is a usually elderly person, chronically affected by multiple illnesses, with an unstable and frequently disabled state of health, whose care needs are determined by factors linked to clinical conditions, socio-family status, environment, accessibility to care. The evaluation of frailty, allows the development of care plans aimed at the real needs of the patient. Identify the tools for assessing frailty in the elderly based on information collected by nurses. Use of the databases Pubmed, CINAHL and COCHRANE, with the mesh terms "frailty, weights and measures, scale". Age limits (65+ years) and language (English and Italian) were set and the references of the selected articles were analyzed. The items of each tool were classified by domain (cognitive, psychological, physical and social). The main characteristics of each instrument were studied, assessing their potential use in nursing care, both of the original scale and of any modified versions. From the 115 selected articles, 13 frailty assessment tools were identified. The tools were classified as one and multidimensional. The one-dimensional instruments are oriented to the physical domain of functioning and biological / physiological state, while multidimensional evaluations are based on the analysis of the interactions of the physical, psychological and social domains of human functioning. There is no standard and internationally agreed on measure for assessing frailty; some measurements are more adequate for screening frailty at the community level, others for a hospital context.