A Qualitative Exploration of Older Patients' Experiences With Frailty and Related Management Strategies

Abstract

BackgroundFrailty is highly prevalent in hospitalized older patients and may increase the risk of adverse health outcomes. Understanding the experiences of older patients and the management strategies they use to recover from frailty is crucial to developing appropriate interventions.PurposeThis study was designed to explore the frailty experiences of older adults and the management strategies they use to recover from frailty.MethodsUsing purposive sampling, semistructured, face-to-face interviews were conducted with 16 older patients with frailty. Data were analyzed using content analysis.ResultsThe experiences of participants were classified into three phases, including the (a) individual sensing phase, (b) daily-living-threatening phase, and (c) acclimatization and acceptance phase. When experiencing frailty, the participants developed management strategies to facilitate recovery, which manifested in three phases: (a) making flexible adjustments to the daily routine, (b) using adequate support systems, and (c) adopting positive thinking.Conclusions/Implications for PracticeThe results indicate that familial support and positive thinking are important management strategies for successful recovery in frail individuals. Older patients require adequate support systems. Positive thinking was also found to be an effective management strategy for recovery. Healthcare professionals should not only focus on providing supportive resources but also provide support to older patients to facilitate their adoption of positive thinking to face life changes brought on by frailty.

Older persons' experiences of frailty: A systematic review

“…For example, physical frailty could contribute to isolation when participants could no longer go out or socialise. In addition, participants alluded to a relationship between a deterioration in mental health and a reduction in physical health (Archibald et al., 2020; Gee et al., 2019; Shaw et al., 2018; Yueh et al., 2023).…”

“…All 19 studies addressed the physical dimension of frailty in terms of physical features, poor health and loss of function. Physically visible signs of frailty were frequently used in the descriptions of frailty with participants using terms such as weak, thin, fragile and bony (Archibald et al, 2020;BritainThinks, 2015;Canbolat Seyman & Sara, 2021;Cluley et al, 2021;Gee et al, 2019;Pan et al, 2019;Søvde et al, 2021;Warmoth et al, 2016;Yueh et al, 2023).…”

“…This included watching sport on television, having the garden indoors and moving one's daytime chair to the window (Nicholson et al, 2013). Housing and equipment modifications and pacing oneself also allowed older people to retain some independence (Yueh et al, 2023). Nicholson et al (2013) introduced the notion of 'anchorage' as a means of living with frailty;…”

“…Nicholson et al (2013) referred to this stage as a loss of autonomy and personhood, while Pan et al (2019) described being at the mercy of others and putting up with things. Seeking help was perceived as challenging; yet, some participants were positive about the services they received, which facilitated them to remain at home (Bjerkmo et al, 2021;Findlay et al, 2017;Nicholson et al, 2012;Yueh et al, 2023). Carers in one study were perceived as the link to the outside world, providing a social stimulus for the older person, as well as performing personal care tasks.…”

“…More recently, there is emerging evidence from the social sciences that broadens the biomedical focus. This evidence acknowledges frailty as more than a physical phenomenon and elucidates a broader and alternative view that includes psychological and social dimensions informed by research that explores the perspectives of older persons (Archibald et al., 2020; BritainThinks, 2015; Chenhuichen et al., 2024; Escourrou et al., 2019; Gobbens et al., 2010; IPSOS MORI, 2014; Lim et al., 2023; Nicholson et al., 2012; Pan et al., 2019; Puts et al., 2009; Waldron, 2018; Warmoth et al., 2016; Yueh et al., 2023). This wider perspective suggests that the older person's view of frailty can differ from that of the healthcare definition, in that older adults can dispute the frailty ratings applied to them using the biomedically dominated frailty assessment tools (Cheung et al., 2021; Cluley et al., 2021; Gee et al., 2019; Puts et al., 2009; Shafiq et al., 2023).…”