Name of frailty item by subject header |
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Psychosocial well-being |
  Not close to someone in facility |
  No strong supportive relationship with family |
  Infrequent participation in longstanding social activities |
  Infrequent visits from friends/family |
  Infrequent interaction with friends/family |
Mood |
  Makes negative statements |
  Persistent anger |
  Unrealistic fears |
  Repetitive health complaints |
  Repetitive anxiety |
  Sad, pained, worried facial expressions |
  Crying, tearfulness |
  Withdrawal from activities of interest |
  Reduced social interactions |
  Lack of pleasure in life |
Cognition |
  Minimally impaired (0.5) or moderate/severely impaired (1) decision-making skills |
  Short-term memory problems |
  Procedural memory problems |
  Situational memory problems |
  Easily distracted |
  Episodes of disorganized speech |
  Declined decision-making last 90 days |
Communication |
  At least some difficulty to make self understood |
  At least some difficulty understanding |
  Moderate/severe hearing problems |
  Moderate/severe vision problems |
Functional status |
  Limited help (0.5), extensive help (1) with phone use |
  Limited help (0.5), extensive help (1) with stair climbing |
  Limited help (0.5), extensive help (1) with shopping |
  Limited help (0.5), extensive help (1) with bathing |
  Limited help (0.5), extensive help (1) with personal hygiene |
  Limited help (0.5), extensive help (1) with dressing upper body |
  Limited help (0.5), extensive help (1) with dressing lower body |
  Limited help (0.5), extensive help (1) with walking |
  Limited help (0.5), extensive help (1) with locomotion |
  Limited help (0.5), extensive help (1) with transferring |
  Minimal help (0.5), extensive help (1) with toilet use |
  Minimal help (0.5), extensive help (1) with bed mobility |
  Minimal help (0.5), extensive help (1) with eating |
  Less than 1 hour of physical activity in last 3 days |
  Did not go out within a 3 day period |
  Declined in ADL over last 90 days |
Incontinence |
  Some (0.5), daily (1) bladder incontinence |
  Some (0.5), daily (1) bowel incontinence |
Disease diagnosis |
  Hip fracture, other fractures, osteoporosis |
  Arthritis |
  Alzheimer’s disease/dementia |
  Hemiplegia |
  Multiple sclerosis |
  Paraplegia/quadriplegia |
  Parkinson's disease |
  Stroke or CVA |
  Hypertension |
  Coronary heart disease |
  Congestive heart failure |
  COPD/Emphysema/Asthma |
  Cancer |
  Diabetes |
  Renal disease |
  Peripheral vascular disease |
  Cardiac arrhythmias |
  Thyroid disease |
Health conditions |
  At least 1 fall in last 30 days |
  Balance - turning around |
  Balance - dizziness |
  Balance - unsteady gait |
  Chest pain |
  Abnormal thought process |
  Delusions |
  Hallucinations |
  Aphasia |
  Vomiting |
  Non-restful sleep/insomnia |
  Too much sleep |
  Peripheral edema |
  Shortness of breath |
  Fatigue - cannot complete day-to-day activities |
  Pain present |
  Poor self-reported health |
Nutrition/Medications |
  BMI 30–40 (0.5), BMI > 40 (1) |
  Weight loss 5% or more in last 30 days or 10% in last 180 days |
  Ten or more medications |
  Allergy to any drug |