I read with interest the frailty practice review by Van Oppen et al in which they suggest that existing emergency department (ED) guidelines and protocols poorly represent older people living with frailty. They recommend that clinicians caring for these patients should not only appraise the available evidence in the context of an individual’s situation and values but also consider the person’s personal preferences to truly deliver person-centred care.1 They highlight the fact that evidenced-based treatment pathways in the ED, which often work well for the younger patients, may predispose the frail older patient to unnecessary repeated investigations of little value to them, losing sight of the issues that matter most to them.1 As frail older patients often have multiple physical and psychosocial problems and may have …