THINK Frailty is a frailty identification tool designed to support clinical decision making in acute hospitals. This tool aids clinical staff in identifying people living with frailty and promotes early access to Comprehensive Geriatric Assessment (CGA).
CGA is a holistic, multi-disciplinary and evidence-based approach which improves outcomes for people living with frailty. Ellis G, Gardner M, Tsiachristas A, Langhorne P, Burke O, Harwood RH, et al. Comprehensive geriatric assessment for older adults admitted to hospital (Review). Cochrane Database of Syst. Rev. 2017; 9
This tool supports screening for frailty as an adjunct to clinical judgment.
It can be used to screen all people over 75 and people resident in care home over 65. For younger people, local guidelines should be consulted.
This tool has been tested in secondary care settings
F: Functional impairment (New or worsening) e.g. difficulty with self care Y/NR: Resident in a care home Y/NA: Altered mental state such as delirium or dementia (use the 4AT) Y/N
I: Immobility/instability. New decline in mobility, difficulty mobilising without help or fall leading up to presentation Y/N
L: Living at home with support on a daily basis (homecare, one visit or more per day) Y/N
Clear need for other specialty input e.g. exacerbation of known long term condition such as COPD Y/NNeed for HDU/ITU (including non-invasive ventilation) Y/NSuspected new stroke or TIA, consider thrombolysis and care in stroke unit Y/NHead injury with loss of consciousness Y/NAcute abdominal pain/ surgical presentation Y/NUpper GI Bleed Y/NChest pain with suspected acute coronary syndrome Y/NTrauma with suspected fracture Y/N
If YES to any criteria in step 2:
If NO to the list in Step 2:
Focus on frailty