Abstract
Despite the many clinical measures of frailty, the voices of frail older people are seldom heard. Understanding how frail older people view ‘frailty’ is vital for informing person-centred care. We conducted qualitative interviews with 14 community-dwelling older people who received frailty services and/or were identified as frail by services. Interviews took place at home or in community hospital, in diverse geographic areas. Thematic analysis was conducted.
Four themes were identified. (1) ‘Living in an ageing body’: ageing was experienced as gradual change, punctuated by falls and illnesses which posed threats to confidence, ability and independence. (2) ‘Adapting to preserve what is meaningful’: older people altered their routines and environments to keep doing what they enjoyed, adopting determined outlooks. Frequent falls/illnesses (‘one-thing-after-another’) were overwhelming, causing fear for the future. Relationships changed as some family/friends became carers; social circles narrowed. (3) ‘Rejecting a frail, old identity’: ‘frailty’ conferred helplessness, (mental) weakness, and loss of dignity. Those interviewed at home did not identify as frail, despite some being house- or bedbound; those interviewed in hospital sometimes reluctantly did. (4) ‘The paradox of accepting care’: accepting care could signify a trajectory towards dependence and residential care, yet care could be enabling and preserve some independence.
A ‘frail’ identity posed an existential threat to community-dwelling older people. Accepting frailty services could undermine the strong mindset and identity which had sustained older people thus far. Attention should be given to how services are presented and delivered, to ensure dignity and autonomy are protected alongside physical safety.
Four themes were identified. (1) ‘Living in an ageing body’: ageing was experienced as gradual change, punctuated by falls and illnesses which posed threats to confidence, ability and independence. (2) ‘Adapting to preserve what is meaningful’: older people altered their routines and environments to keep doing what they enjoyed, adopting determined outlooks. Frequent falls/illnesses (‘one-thing-after-another’) were overwhelming, causing fear for the future. Relationships changed as some family/friends became carers; social circles narrowed. (3) ‘Rejecting a frail, old identity’: ‘frailty’ conferred helplessness, (mental) weakness, and loss of dignity. Those interviewed at home did not identify as frail, despite some being house- or bedbound; those interviewed in hospital sometimes reluctantly did. (4) ‘The paradox of accepting care’: accepting care could signify a trajectory towards dependence and residential care, yet care could be enabling and preserve some independence.
A ‘frail’ identity posed an existential threat to community-dwelling older people. Accepting frailty services could undermine the strong mindset and identity which had sustained older people thus far. Attention should be given to how services are presented and delivered, to ensure dignity and autonomy are protected alongside physical safety.
| Original language | English |
|---|---|
| Publication status | Accepted/In press - 24 Mar 2023 |
| Event | British Society of Gerontology 52nd annual conference - University of East Anglia, Norwich, United Kingdom Duration: 5 Jul 2023 → 7 Jul 2023 https://www.britishgerontology.org/events-and-courses/bsg-annual-conference |
Conference
| Conference | British Society of Gerontology 52nd annual conference |
|---|---|
| Country/Territory | United Kingdom |
| City | Norwich |
| Period | 5/07/23 → 7/07/23 |
| Internet address |