Frailty and Rehabilitation.

Abstract

Rehabilitation approaches to frailty are in the early stages of development. Frailty also shows promise as a prognostic indicator for rehabilitation programs, similar to its application in other areas of medicine. However, care should be taken not to exclude frail older people from rehabilitation, as has been the case at some centers for people with cognitive impairment or very severe disability. There are clear theoretical reasons to expect that a rehabilitation approach will be effective. Some experimental data are also available suggesting that rehabilitation is effective in frail and pre-frail older people. The principles of a frailty intervention program that have been demonstrated to be clinically and economically effective are as follows: first, frailty can be mitigated; second, support needs are individually addressed; third, the interventions aim to improve physical, cognitive and social functioning; fourth, support has to be delivered over a long time period; and finally, systems must facilitate consistent management. Most frail older people are encouraged and supported to adhere to their intervention plan. It is important to recognize the needs of families and/or carers and to engage with them.