Developing a Frailty Care Pathway for Older Adults in Long-Term Care: A Modified Delphi Process

Abstract

Objective: We developed a clinical care pathway for the detection and management of frailty for older adults living in long-term care (LTC) homes.

Methods: We utilized a modified Delphi with residents of LTC homes experiencing frailty, their caregivers, and care providers. The pathway was created using existing literature and input from key LTC experts.

Findings: Fifty-two panelists completed round one of the Delphi, and 55.8% of these respondents completed round two. Both rounds had high agreement and ratings. We added six new statements following analysis of round two, and 15 statements were modified/updated to reflect panelist feedback. The final pathway included 28 statements and promotes a resident-centered approach that highlights caregiver involvement and inter-professional teamwork to identify and manage frailty, as well as initiate palliative care earlier.

Conclusion: Implementing this pathway will allow health care providers to adopt screening measures and adapt care to a resident's frailty severity.

Keywords: care pathway; detection; détection; fragilité; frailty; long-term care; older adults; parcours de soins; personnes âgées; soins de longue durée.