{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T13:59:10Z","timestamp":1769867950094,"version":"3.49.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/100013502","name":"Canadian Patient Safety Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013502","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008874","name":"Canadian Foundation for Healthcare Improvement","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008874","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Can. J. Aging"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0714980825100123_sec01\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We developed a clinical care pathway for the detection and management of frailty for older adults living in long-term care (LTC) homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0714980825100123_sec02\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We utilized a modified Delphi with residents of LTC homes experiencing frailty, their caregivers, and care providers. The pathway was created using existing literature and input from key LTC experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0714980825100123_sec03\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Fifty-two panelists completed round one of the Delphi, and 55.8% of these respondents completed round two. Both rounds had high agreement and ratings. We added six new statements following analysis of round two, and 15 statements were modified\/updated to reflect panelist feedback. The final pathway included 28 statements and promotes a resident-centered approach that highlights caregiver involvement and inter-professional teamwork to identify and manage frailty, as well as initiate palliative care earlier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0714980825100123_sec04\" sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementing this pathway will allow health care providers to adopt screening measures and adapt care to a resident\u2019s frailty severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0714980825100123","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T08:44:49Z","timestamp":1754642689000},"page":"458-464","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Developing a Frailty Care Pathway for Older Adults in Long-Term Care: A Modified Delphi Process"],"prefix":"10.1017","volume":"44","author":[{"given":"Pauline","family":"Wu","sequence":"first","affiliation":[{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayna","family":"Holroyd-Leduc","sequence":"additional","affiliation":[{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"Alberta Health Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2175-6037","authenticated-orcid":false,"given":"Sharon","family":"Kaasalainen","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9462-5460","authenticated-orcid":false,"given":"David B.","family":"Hogan","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-159X","authenticated-orcid":false,"given":"Aynharan","family":"Sinnarajah","sequence":"additional","affiliation":[{"name":"Queen\u2019s University"},{"name":"Lakeridge Health"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Grinman","sequence":"additional","affiliation":[{"name":"University of Calgary"},{"name":"Alberta Health Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Silvius","sequence":"additional","affiliation":[{"name":"University of Calgary"},{"name":"Alberta Health Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica E.","family":"Simon","sequence":"additional","affiliation":[{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4091-9460","authenticated-orcid":false,"given":"Ann Madeline","family":"Toohey","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"McMillan","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Slobogian","sequence":"additional","affiliation":[{"name":"Alberta Health Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Naylor","sequence":"additional","affiliation":[{"name":"Brenda Strafford Foundation"},{"name":"Dr. Barrie Strafford Centre for Learning, Innovation, and Quality"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Hykaway","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Gaetano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Gilroy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandra","family":"Vig","sequence":"additional","affiliation":[{"name":"Alberta Health Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loralee","family":"Fox","sequence":"additional","affiliation":[{"name":"Alberta Health Services"},{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itode Vivian","family":"Ewa","sequence":"additional","affiliation":[{"name":"Alberta Health Services"},{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8858-4076","authenticated-orcid":false,"given":"Zahra","family":"Goodarzi","sequence":"additional","affiliation":[{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"},{"name":"University of Calgary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"S0714980825100123_r10","doi-asserted-by":"publisher","DOI":"10.46747\/cfp.6711e298"},{"key":"S0714980825100123_r29","first-page":"1","article-title":"Editorial: The need to implement frailty in the international classification of disease (ICD)","author":"Muscedere","year":"2020","journal-title":"Journal of Frailty and Aging"},{"key":"S0714980825100123_r39","unstructured":"The Brenda Strafford Foundation Ltd. | Overview . (n.d.). Retrieved April 4, 2023, from https:\/\/thebsf.ca\/research--innovation\/overview.html"},{"key":"S0714980825100123_r1","unstructured":"About Us \u2013 Bethany Seniors . (n.d.). Retrieved April 4, 2023, from https:\/\/bethanyseniors.com\/about-us\/"},{"key":"S0714980825100123_r23","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-020-00599-w"},{"key":"S0714980825100123_r20","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x"},{"key":"S0714980825100123_r7","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-018-0272-x"},{"key":"S0714980825100123_r27","first-page":"655","article-title":"How to use the nominal group and Delphi techniques","volume":"38","author":"McMillan","year":"2016","journal-title":"International Journal of Clinical Pharmacy"},{"key":"S0714980825100123_r36","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15156"},{"key":"S0714980825100123_r38","unstructured":"The AgeCare Difference . (n.d.). AgeCare. Retrieved April 4, 2023, from https:\/\/www.agecare.ca\/about-agecare\/the-agecare-difference\/"},{"key":"S0714980825100123_r16","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002253"},{"key":"S0714980825100123_r21","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-012-1387-2"},{"key":"S0714980825100123_r31","doi-asserted-by":"publisher","DOI":"10.1002\/gps.589"},{"key":"S0714980825100123_r35","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldq024"},{"key":"S0714980825100123_r37","first-page":"306","article-title":"Broadening end-of-life comfort to improve palliative care practices in long term care","volume":"36","author":"Sussman","year":"2017","journal-title":"Canadian Journal on Aging\/La Revue Canadienne Du Vieillissement"},{"key":"S0714980825100123_r14","doi-asserted-by":"publisher","DOI":"10.1007\/s00391-016-1134-x"},{"key":"S0714980825100123_r32","unstructured":"Qualtrics XM \u2013 Experience Management Software . (n.d.). Qualtrics. Retrieved March 19, 2024, from https:\/\/www.qualtrics.com\/"},{"key":"S0714980825100123_r11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"S0714980825100123_r24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.06.025"},{"key":"S0714980825100123_r34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1991.tb05927.x"},{"key":"S0714980825100123_r33","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"S0714980825100123_r28","unstructured":"Microsoft Excel Spreadsheet Software | Microsoft 365 . (n.d.). Retrieved October 11, 2024, from https:\/\/www.microsoft.com\/en-ca\/microsoft-365\/excel"},{"key":"S0714980825100123_r19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2019-001953"},{"key":"S0714980825100123_r40","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.13096"},{"key":"S0714980825100123_r30","first-page":"281","article-title":"Screening for frailty in Canada\u2019s health care system: A time for action","volume":"35","author":"Muscedere","year":"2016","journal-title":"Canadian Journal on Aging\/La Revue Canadienne Du Vieillissement"},{"key":"S0714980825100123_r8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020476"},{"key":"S0714980825100123_r18","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-021-02271-1"},{"key":"S0714980825100123_r12","doi-asserted-by":"publisher","DOI":"10.1177\/0145482X1510900215"},{"key":"S0714980825100123_r25","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S168750"},{"key":"S0714980825100123_r9","unstructured":"Buckinx, F. (2017). Prevalence of frailty in nursing home residents according to various diagnostic tools. The Journal of Frailty & Aging, 6(3), 7."},{"key":"S0714980825100123_r6","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7034-4"},{"key":"S0714980825100123_r17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-037466"},{"key":"S0714980825100123_r22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7001.376"},{"key":"S0714980825100123_r13","doi-asserted-by":"publisher","DOI":"10.1080\/13611260500069947"},{"key":"S0714980825100123_r15","first-page":"14","article-title":"Association of frailty and pre-frailty with increased risk of mortality among older Canadians","volume":"32","author":"Gilmour","year":"2021","journal-title":"Health Reports"},{"key":"S0714980825100123_r5","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X707861"},{"key":"S0714980825100123_r4","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120907602"},{"key":"S0714980825100123_r26","doi-asserted-by":"publisher","DOI":"10.14283\/jfa.2021.51"},{"key":"S0714980825100123_r3","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.13003"},{"key":"S0714980825100123_r2","doi-asserted-by":"publisher","DOI":"10.1177\/08445621221079534"}],"container-title":["Canadian Journal on Aging \/ La Revue canadienne du vieillissement"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0714980825100123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T12:02:14Z","timestamp":1769688134000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0714980825100123\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["S0714980825100123"],"URL":"https:\/\/doi.org\/10.1017\/s0714980825100123","relation":{},"ISSN":["0714-9808","1710-1107"],"issn-type":[{"value":"0714-9808","type":"print"},{"value":"1710-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of The Canadian Association on Gerontology","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (http:\/\/creativecommons.org\/licenses\/by-nc\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}