Frailty is frequently undiagnosed, which means that people might be living with frailty without realising it.
Identifying people who are living with frailty can be difficult for health practitioners, particularly when they are not already known to a particular service.
By identifying people living with frailty as soon as possible, healthcare services can provide appropriate support such as:
palliative rehabilitation
prescribing effective medication (and deprescribing medication that is no longer effective)
wellbeing education
supporting self-management of symptoms
pre-bereavement support for carers and families.
Identifying end of life
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Although frailty is a leading cause of death in older people, it is often not recognised nor considered at end of life [1].
It's particularly important to be able to identify when patients living with frailty are approaching the end of their lives, to make sure their needs and wishes are recognised and being met.
Hospices can facilitate training for GPs, care home staff, domiciliary care providers and healthcare workers in other settings, giving them the tools to recognise frailty and ensure patients receive appropriate care before reaching a crisis.
having sensitive conversations with patients who have advanced frailty needs
advance care planning.
The earlier frailty is recognised, the sooner support can be put in place.
Raising awareness among the patients and families
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It's equally important to educate patients and their loved ones. This can help:
increase their awareness of what frailty is and any associated risk factors
provide advice on making behavioural changes to support their wellbeing
make them aware of other community services they can engage with if needed.
It's important to have an holistic approach, so that people can get frailty support and advice from any health professionals they might be involved with.
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“Frailty support is not always readily available, and the process must be even harder for those with little knowledge or limited personal support.
This has made us realise the importance of not only educating the patient, but also empowering their carer to be proactive in getting the right support at the right time.”
Isabel Hospice
How hospices can help
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The hospices that took part in our Extending Frailty Care programme employed a range of approaches to help raise awareness of frailty, its symptoms and the support available.
This programme ran from April 2022 to March 2025, with the generous support of the Kirby Laing Foundation.
St Catherine’s Hospice in West Sussex reached out to several local groups to help deliver educational sessions to potential patients and carers. This included:
the fire brigade
the local ‘Men’s Shed’
groups hosting Qigong lessons
exercise classes
art classes
social groups
gardening groups.
The sessions lasted for two hours. The first hour was a presentation explaining what fraitly is and how it affects people. In the second hour, local services explained what they do to support people living with frailty.
Following the session, several attendees reported increasing their exercise and joining a local social club. Many said they now have a greater awareness of future care planning.
St Christopher’s Hospice in South London identified that older people living with frailty in residential homes rarely engaged with palliative care. They approached six residential care homes to see how they could raise awareness of the support available from the hospice.
The sessions the hospice led at the care homes revealed that residents were very keen to talk about what matters most to them at the end of life. This led to more patients thinking about their wishes for the future and writing advance care plans.
Older people do not necessarily identify with the term ‘frail’ [2]. To some people, 'frailty' can symbolise losing independence, dignity and control over one’s life. Their study recommends using specific examples of living with frailty instead, to encourage self-identification.
Isabel Hospice in Hertfordshire amended the name of their ‘Frailty Awareness Programme’ to ‘Ageing Well’, to avoid putting off people who do not identify with the term 'frailty'. This helped widen participation in their programme.
