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Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description

OBJECTIVES: Despite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to un...

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Autores principales: Archibald, Mandy, Lawless, Michael, Ambagtsheer, Rachel C, Kitson, Alison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150596/
https://www.ncbi.nlm.nih.gov/pubmed/32193272
http://dx.doi.org/10.1136/bmjopen-2019-035339
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author Archibald, Mandy
Lawless, Michael
Ambagtsheer, Rachel C
Kitson, Alison
author_facet Archibald, Mandy
Lawless, Michael
Ambagtsheer, Rachel C
Kitson, Alison
author_sort Archibald, Mandy
collection PubMed
description OBJECTIVES: Despite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive–descriptive qualitative study. SETTING: Aged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia. PARTICIPANTS: 39 non-frail, prefrail, frail and very frail South Australian older adults. METHODS: Seven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators. RESULTS: Frailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail. CONCLUSIONS: Aside from a disability model, views of frailty as unmodifiable permeated older persons’ diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective.
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spelling pubmed-71505962020-04-18 Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description Archibald, Mandy Lawless, Michael Ambagtsheer, Rachel C Kitson, Alison BMJ Open Geriatric Medicine OBJECTIVES: Despite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive–descriptive qualitative study. SETTING: Aged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia. PARTICIPANTS: 39 non-frail, prefrail, frail and very frail South Australian older adults. METHODS: Seven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators. RESULTS: Frailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail. CONCLUSIONS: Aside from a disability model, views of frailty as unmodifiable permeated older persons’ diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective. BMJ Publishing Group 2020-03-18 /pmc/articles/PMC7150596/ /pubmed/32193272 http://dx.doi.org/10.1136/bmjopen-2019-035339 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Geriatric Medicine
Archibald, Mandy
Lawless, Michael
Ambagtsheer, Rachel C
Kitson, Alison
Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
title Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
title_full Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
title_fullStr Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
title_full_unstemmed Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
title_short Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
title_sort older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
topic Geriatric Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150596/
https://www.ncbi.nlm.nih.gov/pubmed/32193272
http://dx.doi.org/10.1136/bmjopen-2019-035339
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