Welcome back to Clinical Insights.
In my first post, I spoke about the opportunity this blog gives us to explore some of the challenges aged care providers face every day and share practical insights that support safe, quality care.
As Chief Clinical Advisor, one of my goals is to help connect new and emerging evidence with the realities of delivering care, so we can better support older people to make informed choices about their care. This month, I’m focusing on frailty, why it matters and what providers can do to better identify and respond to it, helping older people maintain their health, independence and quality of life for longer.
It is true that almost all (99%) of Australian aged care residents are frail (Department of Health, Disability and Ageing, 2025). One could also predict that most Support at Home recipients are frail. Being described as frail is something which many older people find difficult to accept because it’s misunderstood as a negative label or judgement. But in clinical practice, frailty is a very useful concept. It helps us understand the care needs and unique vulnerabilities of older people receiving aged care.
Frailty reminds us that we can’t remove all risk, and sometimes our actions to keep an older person safe can create further risks.
This is why person-centred care is so critical. Providers need to understand the expectations and preferences of older people well, to plan for and to support them to manage the competing risks to their health.
Understanding the person
Quality care must start with understanding the person. What matters to them? What do they want to achieve? What activities bring them joy? What worries them the most? And what risks are they prepared to take to stay independent and enjoy a better quality of life?
These types of questions are the foundation for compassionate aged care practice that puts the older person first.
Frailty then gives us a way to think about the risks related to care. It reminds us that care and risk can be connected, that care decisions may involve trade-offs, and that a strategy to reduce one risk may unintentionally increase another. When older people are given the right information to understand the risks, they can work with their clinicians, care workers, families and supporters to make informed decisions – together.
Take falls prevention as an example. An older person may be falling more often. In response, workers might encourage them to stay seated more often. They might even give them more help with mobility and transfers. They may even use a restrictive practice. At first, this can seem successful because the person falls less often. However, over time, reducing movement will cause muscle weakness, loss of confidence and declining physical function. As the person's frailty increases, they’re very likely to be less independent than they were before. In trying to address one risk, we may have created others.
This doesn’t mean that the providers’ attempt to reduce the person’s number of falls was wrong or misguided. It highlights the importance of taking a step back and looking at the full picture. The goal shouldn’t just be to reduce or stop falls. The goal should be to support the person’s overall wellbeing, independence and quality of life, while still managing risk.
Frailty and person-centred care
Frailty is a valuable framework through which to view best practice, person-centred care. It encourages us to look beyond a single clinical issue and consider the connected factors that affect a person's health and wellbeing. It helps us ask better questions and have deeper conversations about what matters most to the older person.
Importantly, frailty also helps us identify opportunities to improve outcomes in other areas. For example, supporting older people to stay strong and mobile through good nutrition, exercise and physical activity can have many health benefits. Improved muscle strength can reduce falls risk, support independence, improve confidence and slow frailty from progressing.
There are excellent resources for providers who want to learn more about frailty, including:
- Frailty - Sydney North Health Network
- Australian Consensus Statement on the Prevention and Management of Frailty Among Community‐Dwelling Older Adults: A Modified Delphi Study
- Consensus document on frailty: conceptualization, detection, multidisciplinary management and future roadmap
They show how to use frailty-informed approaches in care planning and clinical decision-making. I encourage you to explore these resources and think about how they can support your conversations with older people, their families and supporters.
Future focus - governance
Next month, I’ll turn my attention to clinical and care governance, an area that’s often incorrectly seen as the responsibility of clinical experts alone. I'll explore how a practical understanding of governance can help providers better identify risks, make informed decisions and continuously improve the care and services they provide.
Thank you for taking the time to read this blog. I hope it’s inspired you to think about the important role you play in identifying, preventing and responding to frailty.
If there’s another topic you'd like to see us cover in a future blog, we’d love to hear about it. You can email us at OfficeOfChiefClinicalAdvisor@agedcarequality.gov.au.
Until next time,
Mandy