it is not feasible for everyone with frailty (from mild up to severe, life-limiting frailty) to undergo a full multi-disciplinary review with geriatrician involvement (BGS, 2014).

Nevertheless, all patients with frailty will benefit from a holistic medical review based on the principles of CGA.

 

It is suggested that after the brief CGA is completed, a decision is made as to which patients require a more in-depth CGA and who will be involved in carrying it out.

This decision is best reached through discussion in a Multi-Disciplinary Team (MDT) meeting.
Where a MDT is not available to the GP, the decision is reached by the practice lead in consultation with other proactive team members in the practice.

 

In-depth CGA involves a holistic, multi-dimensional, interdisciplinary assessment of an individual by a number of specialists of many disciplines in older people’s health, usually including a geriatrician (BGS, 2014).

Again, where access to appropriate specialists or geriatrician is limited or subject to lengthy delays or untenable financial constraints for the patient, the GP may have no option but to devise a viable plan for the in-house execution of the selected required in-depth CGA elements.

 

The GP medical record system, be it paper-based or electronic, will require adaptation to embrace the recording and periodic updating of the CGA findings.

AGEDAT is a paper template suitable for this purpose.

Electronic Medical Record (EMR) updates are under development for various EMR propriatory systems