Neurologists increasingly care for people with significant frailty in both clinic and ward settings. Such care demands a balanced approach to investigation, diagnosis and treatment, as well-intentioned actions can produce adverse effects. This article presents a practical approach to the identification and management of patients with frailty and neurological conditions. We address medicines optimisation, common causes of deterioration in those with frailty, communication, decisions about intensity of treatment, and shared decision-making including ethical aspects of withholding or withdrawing life-prolonging treatment, with a view to improving the experience both of people living with frailty and of the teams who care for them.
- clinical neurology
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Contributors LP and MS wrote the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned. Externally peer reviewed by Susan White, Cardiff, UK, and John Thorpe, Cambridge, UK.