These findings highlight the perspectives of older people and their relatives on the delivery of personalized and dignified care in acute settings. They lend support to previous calls for relationship-centred approaches to care and provide a useful experience-based framework for practice for those involved in care for older people.

This is the unspecified version of the paper.This version of the publication may differ from the final published version. The social gerontological literature suggests that constructs of frailty are diverse. Gilleard and Higgs (2010b) posit that culturally those deemed frail have few self-empowering narratives. They argue that frailty is held within a social imaginary as a black hole, a socially void space into which older people are sequestrated away to decay and die. Thus within a social imaginary frailty, like a black hole, is both unknowable and a space from which there is no return. Permanent repository link 4Hockey and James (2003) argue that social identities in late old age can be conceptualised as liminal. Liminality (after Turner (1974)) is a threshold space, a transitional point between social structures. Such spaces are fluid, allow for the potential redefinition of self-identity and can even be a position of power. Thus although older 'liminal' individuals are placed in an uncertain outsider status this social positioning can provide a space from which "weak" elders exert power. The vulnerability of old age can expose the very decline and dependency from which wider society seeks to distance itself. Thus identities are not fixed nor necessarily related to dominant understandings of a declining body. Grenier (2006bGrenier ( , 2007 develops this thesis in her work on the subjective experience of older frail people. She and others (Becker, 1994;Kaufman, 1994) argue that frail elders themselves differentiate between being and feeling frail. The label of frailty is actively resisted as elders distinguish between the body one is (selfidentity) and the body one has -a physical, vulnerable, and objectified social identity.Within Western welfare policy and practice frailty is increasingly used as a means of classification, to prioritise and fund care. Indeed, clinically frailty is often used as a This paper draws on findings from a longitudinal study of the subjective experience of being a frail older person living at home. The aim of the study was to understand the experience of home-dwelling older people living with frailty over time in order to develop the empirical evidence base for this group and to consider more fully how narratives of frailty can shape person-centred care provision. MethodsTo capture the dimensions of social, psychological and physical frailty, the research design used a combined qualitative psychosocial method. Psychosocial research conceptualises experience as a constant and dynamic communication between internal psychological and external sociological dimensions manifest through unconscious or feeling states, and conscious communication (Hollway, 2004;Roseneil, 2006 Trust. All participants received written and verbal information about the study and informed consent was confirmed at each cycle of data collection. All were assured of confidentiality and that pseudonyms would be used in all research reports. Data collectionTwo psychosocial narrative approaches; the Biographic Narrat...

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The changing roles of registered nurses have direct implications for the roles of health care assistants: as registered nurses take on extra duties and responsibilities they are conceding some of their role to health care assistants. This has implications for nurse managers. The competence of health care assistants to carry out nursing work needs to be reassessed and there also needs to be ongoing monitoring and supervision of their work to maximize, and further develop, their contribution to patient care and to ensure quality standards. Managers also need to be aware of the importance of workplace negotiations in the interpretation of formal policies and the subsequent shaping of health care assistants' work at the level of service delivery.

Registered nurses need to have an understanding of the concept of personhood to make sense of the various person-centred practice frameworks that exist. Without this understanding, there is a danger that the essence of personhood may be lost in the zeal to implement particular models and frameworks.