The central aim of all care offered to people living with frailty is to improve their experience and quality of life.
Quality of life is a term that refers to the overall wellbeing experienced by individuals. It is recognised as a general term in every day language, with a subjective and personal meaning. However, the term can also be used in a more technical sense, and quality of life can be measured through various quantitative scales according to the particular setting and circumstances.
Both of these approaches are useful when considering the wellbeing of people with frailty. It is always very important to have a subjective and / or colloquial description and understanding of how somebody is feeling about their own quality of life. It can also sometimes be helpful to make a more objective assessment or measurement of the quality of life of a person with frailty, although this applies mostly in the context of research into frailty.
Either the way, the quality of life experienced by a person with frailty is a much wider concept than the simple impact of their health and functional capacity. Instead it depends upon the many complex interactions between the domains describe within our model of frailty:
- Social Environment
- Physical Environment
- Psychological Status
- Multimorbidity (Long-term Conditions)
- Acute Health Events
- Systems of Care
The relative importance, impact and significance of the different components that contribute to overall quality of life vary between individuals, and for the same individual over time. Health professionals can tend to over emphasise the contribution of factors that they can easily recognise and measure, such as the presence and / or severity of conditions and diseases with which they are familiar. However, older people and their carers particularly tend to emphasise the importance of emotional and social factors to overall quality of life. Research has also shown that as overall levels of frailty increase, the priorities which people give to the different aspects contributing to quality of life change, with non-frail people reporting good health as one of the most important factors, whilst people living with frailty place greater emphasis upon the importance of social contacts.
The overall quality of life experienced by a person with frailty therefore depends upon the combined balance between resilience and vulnerability across all their domains of frailty and how this relates to the individual’s priorities.