Abstract
ABSTRACTInnovative methods to manage frailty are critical to managing the needs of an ageing population. Evidence suggests there are opportunities to reverse or prevent frailty through early intervention. However, little is known about older adults’, families’ and practitioners’ beliefs about the malleability of frailty. This study examined European stakeholders’ accounts of the acceptability and feasibility of frailty screening and prevention to inform future intervention development. Semi-structured focus groups and individual interviews were conducted in three European Union countries (Italy, Poland and the United Kingdom) with key stakeholders – frail and non-frail older adults, family care-givers, and health and social care professionals. Thematic analysis identified four themes: synchronicity between the physical and the psychological in frailty, living with frailty in the social world, the need for a new kind of care, and screening for and preventing frailty. Findings emphasised the need for a holistic approach to frailty care and early intervention. Integrated care services and advocacy were important in the organisation of care. Central to all stakeholders was the significance of the psychological and social alongside the physical elements of frailty and frailty prevention. Support and care for older adults and their family care-givers needs to be accessible and co-ordinated. Interventions to prevent frailty must encompass a social dimension to help older adults maintain a sense of self while building physical and psychological resilience.
Highlights
Frailty is a multi-dimensional, clinical condition characterised as a state of increased vulnerability to adverse health outcomes when exposed to a stressor, for example, a chronic disease diagnosis, an acute infection or a fall (Clegg et al ; Lang et al ; Topinková )
Screening cannot be implemented in isolation but must be accompanied by a transparent pathway to care, intervention and support services for older adults and their family care-givers; we found that underpinning all of this is the significance of human relationships and connections to the social world, whether that is through personalised care or through facilitating the maintenance of existing friendships and hobbies that become difficult as incapacities develop
Frailty is a complex phenomenon with multifaceted component parts
Summary
Frailty is a multi-dimensional, clinical condition characterised as a state of increased vulnerability to adverse health outcomes when exposed to a stressor, for example, a chronic disease diagnosis, an acute infection or a fall (Clegg et al ; Lang et al ; Topinková ). Evidence suggests that frailty is a dynamic process, transitioning from robustness through a sometimes clinically silent, pre-frail condition to a frail outcome (Ferrucci et al ). During this process, total physiologic reserves dissipate and individuals become less able to remain active and cope with daily stressors or acute illnesses. Changes to diet alone are less successful in preventing or reversing frailty without an associated exercise component (Zuliani et al ), an adequate intake of protein, calories and vitamin D are critical (Zuliani et al )
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