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Integrating Frailty into Chronic Disease Management: Enhancing Care for Older Adults living with Complexity

Unrecognized or unmanaged frailty can impact the achievement of desired outcomes for individuals living with chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF), Diabetes Mellitus (DM), etc. The Guidance Document details a practical, 4-step approach for integrating frailty-informed care into Chronic Disease Management for older adults. Frailty is a dynamic condition that influences clinical outcomes, self-management capacity, and risk of harm. Identifying and addressing frailty early allows primary care providers and specialty care teams to tailor care plans, mobilize appropriate supports, and improve quality of life.


Related Resources:

Related Resources

Related Resources

Ontario Health East Adult Day Program Guidelines

Caregiver Needs Assessment & Support in Community Specialized Geriatric Services Guidance Document

Frailty Screening and Management in Community Poster

ALC Prevention in the Community

Caregiver Needs Assessment and Support in Primary Care Guidance Document

Frailty Screening and Management in Primary Care Poster

Preventing Hospitalization and Extended Stays for Older Adults (ALC Leading Practices Guide)

Older Adult focused Social Prescribing Programs & Services Presentation and Template

PGLO Care Partner Experience Survey

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