Abstract：
Frailty is a common geriatric syndrome characterized by a decline in physical and cognitive abilities and an increased vulnerability to stressors such as illnesses and injuries. As the global population is aging, the prevalence of frailty is growing. Frail older adults are at substantial risk of developing mobility and self-care difficulties, hospitalization, and death. Frailty is also associated with a high symptom burden and psychosocial stress, including malnutrition, pain, fatigue, weakness, cognitive loss, depression, falls, and sleep disorders, among others. The role of palliative care is gaining attention in medical literature because frailty is associated with increased morbidity and mortality. While there are no specific guidelines yet for when palliative care should be consulted in older patients with frailty, it has been proposed that palliative care should be considered in frail patients with continued functional decline, increased healthcare utilization, and uncontrolled symptoms. Palliative care can aid in communication with patients and families, establishing goals of care and treatment preferences, improving pain and symptom control, addressing psychosocial and spiritual needs, advance care planning, caregiver needs, and end-of-life care. Once frailty is identified, a comprehensive evaluation of the patient\'s physical, psychosocial, and spiritual aspects of care is essential for establishing a patient-centered treatment plan. This paper aims to guide clinicians in providing patient-centered care for older adults with frailty in the outpatient setting. Through a comprehensive literature review, we describe the leading models of frailty, frailty screening tools used in the clinical setting, and the assessment and management of palliative care needs in frail patients. We also describe emerging models of care focusing on palliative care for older adults with frailty and discuss issues related to access to palliative care for this population.
摘要：
虚弱是一种常见的老年综合征，其特征是身体和认知能力下降，对疾病和受伤等压力源的脆弱性增加。随着全球人口的老龄化,虚弱的患病率正在增长。虚弱的老年人有很大的流动性和自我护理困难的风险，住院治疗,和死亡。虚弱还与高症状负担和心理社会压力有关，包括营养不良,疼痛,疲劳,弱点,认知丧失,抑郁症,falls,和睡眠障碍，在其他人中。姑息治疗的作用在医学文献中越来越受到重视，因为虚弱与发病率和死亡率的增加有关。虽然目前还没有具体的指南，说明老年虚弱患者何时应进行姑息治疗，有人建议，对于持续功能下降的虚弱患者，应考虑姑息治疗，提高医疗保健利用率，不受控制的症状。姑息治疗可以帮助与患者和家属沟通，建立护理和治疗偏好的目标，改善疼痛和症状控制，解决社会心理和精神需求，提前护理计划，看护者需要,和临终关怀。一旦发现脆弱，对患者身体的综合评估，社会心理,精神方面的护理对于建立以患者为中心的治疗计划至关重要。本文旨在指导临床医生在门诊为虚弱的老年人提供以患者为中心的护理。通过全面的文献综述，我们描述了脆弱的主要模型，在临床环境中使用的脆弱筛查工具，以及体弱患者姑息治疗需求的评估和管理。我们还描述了新兴的护理模式，重点是针对虚弱的老年人的姑息治疗，并讨论了与该人群获得姑息治疗有关的问题。
