This report, published in June 2015, was jointly commissioned by the BGS and Age UK to provide qualitative research ‘to gain insights that can be used to help raise awareness of approaches to care that can prevent or minimise the impact of frailty on older people’. It covers three main areas:
- Responses to the language of frailty;
- Articulating the concept of frailty;
- Attitudes to support, to prevent and manage frailty.
Three groups of individuals were interviewed using both open and semi-structured methods:
- Health and Care Professionals with some specialism in caring for older people;
- Health and Care Professionals with no particular specialism in caring for older people;
- Members of the public aged 69 yrs and over (some living with frailty and some not).
The main findings were:
- A gulf in language exists between the health care professionals and older people. This is highlighted by the perception of the general public audiences and the non-specialist health care professionals that frailty is often associated with a malnourished, highly dependent and irreversible state of living.
“Frail is when someone is weak, and can’t do anything much. It is that stage where you become dependent on people for most things.” Male interviewee not living with frailty
“No, I’m definitely not frail. Frail means you’re doddery and shaky. You can’t do anything
at all.” Female interviewee living with frailty
“It’s used in end of life care for patients with cancer or very old age.” GP with more than 10yrs experience
- The biggest priority for the older people tended to be maintaining their independence, and they articulate their physical and mental well-being in terms of being able to complete everyday tasks independently. Through the research, a five-point Scale of Independence was developed that highlighted trigger points when individuals may be more inclined to seek out support.
“I switched to a smaller hoover but now even that is too much for me to push around on most days. It’s made me realise that I do need to let my daughters do things for me.” Female (71) living with frailty
- Most of the older people in the sample reported that they would not automatically look for external sources of support on experiencing the clinical symptoms of frailty. Even those who did say that they might look for some support did not consider the GP to be the most appropriate port of call in the first instance.
“Why on Earth would I tell my GP it’s taking me longer to do the ironing and I can’t get out into the garden anymore?! He’s a serious doctor who I go to when I’ve got an ailment, he doesn’t need to be bothered with that rubbish.” Female (73) mildly frail
- Awareness of the Comprehensive Geriatric Assessment(CGA) was extremely low among all audiences.
“The idea is that support should be more integrated, I know, and consultants from the nearest hospital are doing a lot more to try to get out into the community so it’s more joined up. But I haven’t heard it called that at all, no.”
GP with more than 10 years experience
- The report concludes with hypotheses as to what is needed to encourage older people to engage with preventative strategies, many of which relate to supported self-care, such as comprehensive sign-posting of the range of services available to older people and their entitlements, integrated assessments and building awareness of risk factors for frailty (and hence reduced independence).
Visit the Age UK website for care professionals
Visit the British Geriatric Society website