Frail Elderly Syndrome | Medical Algorithm

Dworkin et al identified a number of concerns that need to be considered while managing an elderly patient who is vulnerable or frail.

General problems:

(1) pain and its adverse consequences

(2) decreased appetite and poor nutrition

(3) limited physiologic reserves if acutely stressed

(4) need for prolonged recuperation

(5) declining immunity

(6) inadequate sleep

(7) deterioration in eyesight and/or hearing

Drug therapy:

(1) decreased glomerular filtration rate, with need for dosage adjustments

(2) comorbid conditions that may be worsened by medications

(3) therapy with multiple medications with risk of drug interactions

(4) adverse cognitive effects of medications (delirium, dementia)

Psychological issues:

(1) depression and anxiety

(2) social isolation and loneliness

Functional decline

(1) physical impairment and need for assistance in activities of daily living

(2) impaired mobility

(3) physical weakness

Concerns with prolonged care:

(1) pressure ulceration

(2) incontinence

(3) financial problems

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Concerns for Managing a Frail, Elderly Patient