Front Door Frailty (JRH)

Front door frailty service (Emergency department JRH)

Monday - Friday 0900-1700

Front door frailty registrar – Bleep 6292 

Frailty nurse – Bleep 8331 

Aims:

• For review of patients with CFS 6 or more 
• For hospital admission avoidance, >65 years, any CFS score 
• For review of patients presenting with frailty syndrome and referrals to appropriate community services
  
  

Clinical frailty score

Record on EPR: Interactive view -> Clinical frailty inbox -> select the score by clicking the empty box and click "P top left side.   

Note: if anyone needs 'care' (POC, live-in care, or care home, at baseline when "well"), they will score 6 or above 

CFS 1 to 9 

1. Very fit (Think of the Olympic champion -the fittest of the age group)
2. Think of yourself (no limitation of daily activities)
3. Symptoms managing 
4. Symptoms limiting
5. Needs housework help but not personal care
6. Needs help with washing, dressing and toileting — has care needs (so roughly, if your patient usually needs a commode and transfer assistance, go for 6!)
7. In addition to above, needs help with personal hygiene 
8. Bed bound 
9. Terminally ill (any functional or cognitive status) 

Cognitive screening for patients >65 years

Record on EPR:  Adho -> cognitive screening -> 4AT or AMTS+4AT 

Think 3Cs

Cognitive screening:          4AT or AMTS/4AT  

Collateral: Review ambulance sheets, hx from family/carer

Checklist for assessment/management  

• Pain
• Infection/sepsis
• Nutrition and hydration
• Constipation and Urinary retention
• Hypotension, hypoxia, hypoglycaemia 
• Electrolyte abnormalities-hyponatremia, hypercalcemia
• Sensory impairment- hearing aids, glasses
• Medications- sedatives
• Environment