# Being screened for frailty in the emergency department: the voice of patients in an exploratory qualitative study

## TL;DR

This study explores how older patients feel about being assessed for frailty in the emergency department using the Clinical Frailty Scale.

## Contribution

It provides new insights into patient experiences and communication needs during frailty screening in emergency care.

## Key findings

- Most patients viewed the frailty assessment positively or indifferently.
- Patients emphasized the importance of staff communication and rapport during the assessment.
- Patients often struggled to understand the purpose and outcomes of the assessment.

## Abstract

Frailty assessment is recommended in the emergency department (ED). Despite the widespread use of the Clinical Frailty Scale (CFS), little is known about how patients experience being assessed for frailty in an ED setting. The aim was to investigate patients’ experiences of frailty assessment with the CFS at the point of ED care.

This study adopted a qualitative design, including video-recorded clinical encounters in which the CFS assessment was performed, as well as semi-structured interviews with patients. For analysis, thematic analysis was conducted.

A total of 21 patients aged ≥65 years were recruited using purposive sampling. Four themes were identified—namely, Shaping the CFS experience, Meaning of the assessment, Missing the point, and Reflecting on ageing. In general, older patients viewed CFS assessment in the ED positively or indifferently. They highlighted the importance of the staff employing active listening and building rapport during the assessment, as this made the patients feel comfortable and willing to share information about their situations. Although patients occasionally struggled to understand the purpose and consequences of the assessment, they interpreted its meaning as relating to their health status or need for assistance.

Most older ED patients experience CFS assessment as positive or indifferent, underscoring the importance of relationship-oriented communication to build trust and ensure quality in the frailty screening. The findings further emphasise the need for clarification of the purpose and potential outcomes of the assessment, as these were not always clear to patients.

The study was registered at ClinicalTrials.gov (identifier: NCT06621290) on September 30, 2024.

The online version contains supplementary material available at 10.1186/s12877-026-06990-1.