Becoming frail: a major turning point in patients’ life course

Escourrou, Emile; Herault, Mickael; Gdoura, Samy; Stillmunkès, André; Oustric, Stéphane; Chicoulaa, Bruno

doi:10.1093/fampra/cmy043

Cited by 17 publications

(19 citation statements)

References 24 publications

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“…A similar knowledge gap was cited in a qualitative study of HCPs and frailty in the UK 21 . While mixed views were expressed about frailty terminology among HCPs and patients, in agreement with the literature, the majority of participants expressed a strong aversion to the dialogue of frailty [22][23] . One participant suggested that frailty terminology may be misjudged by clinicians if not universally understood.…”

Section: Discussionsupporting

confidence: 57%

Managing frailty in an Irish primary care setting: A qualitative study of perspectives of healthcare professionals and frail older patients

Kennedy

Galvin

Horgan

2021

JFSF

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Little is known about the views of key stakeholders on frailty in Primary Care in Ireland. The aim of this study was to explore the views of Irish healthcare professionals and patients on frailty and its management in Primary Care. Methods: A qualitative descriptive design was used. Seventeen healthcare professionals and three patients were recruited using purposive sampling. Data were collected using semi-structured interviews which were analysed thematically. Results: Three themes were identified: (i) Perceptions of Frailty (ii) Current Management of Frailty and (iii) Comprehensive Geriatric Assessment in Primary Care. The results demonstrated variability in perspectives on frailty. Healthcare professionals described a fragmented service often delivering substandard care to frail older patients. The general consensus was that frailty management required an adequately resourced Primary Care service. Support for frailty screening and Comprehensive Geriatric Assessment was evident while the suitability of the current pathway for patients requiring assessment was questioned. Conclusion: This study highlights an absence of a shared and complete understanding of frailty among healthcare professionals and a fragmented model of care for community-dwelling frail older patients. Based on these findings, inter-professional training, investment in Primary Care, the development of a frailty pathway and an interface service is recommended.

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Section: Discussionsupporting

confidence: 57%

Managing frailty in an Irish primary care setting: A qualitative study of perspectives of healthcare professionals and frail older patients

Kennedy

Galvin

Horgan

2021

JFSF

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“…Primary studies included in review (n =8) a specific health event/turning point (e.g., stroke or fall), which caused persons to cross a threshold and become "frail" (Escourrou et al, 2017(Escourrou et al, , 2019Skilbeck et al, 2018). Once persons were living with frailty, participants perceived that further decline would follow (Grenier, 2006).…”

Section: Narrative Summary Of Themesmentioning

confidence: 99%

“…Once persons were living with frailty, participants perceived that further decline would follow (Grenier, 2006). The process of "becoming frail" was described as an inevitable part of the aging process (Age UK, British Geriatrics Society, 2015; Escourrou et al, 2017Escourrou et al, , 2019Grenier, 2006Grenier, , 2007Puts et al, 2009;Schoenborn et al, 2018;. A participant explained, "Frailty is not something that you can prevent, you cannot do anything, it just happens when you get older" (Puts et al, 2009, p. 264).…”

Section: Narrative Summary Of Themesmentioning

confidence: 99%

“…Individuals who were dependent on others, lacked confidence, and had a negative outlook on life were perceived as having "a frail state of mind" (Age UK, British Geriatrics Society, 2015; Schoenborn et al, 2018). Cognitive changes (e.g., forgetfulness, difficulty concentrating) were also perceived as characteristics of psychological frailty (Escourrou et al, 2017(Escourrou et al, , 2019Puts et al, 2009). Overall, psychological frailty was perceived as contributing to an emotional experience that led to classification and self-identification as frail (Grenier, 2006(Grenier, , 2007.…”

Section: Psychological Frailtymentioning

confidence: 99%

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Older Adults’ Perceptions of Frailty Language: A Scoping Review

et al. 2021

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There is growing interest in conceptualizing and diagnosing frailty. Less is understood, however, about older adults’ perceptions of the term “frail”, and the implications of being classified as “frail”. The purpose of this scoping review was to map the breadth of primary studies; and describe the meaning, perceptions, and perceived implications of frailty language amongst community-dwelling older adults. Eight studies were included in the review and three core themes were identified: (1) understanding frailty as inevitable age-related decline in multiple domains, (2) perceiving frailty as a generalizing label, and (3) perceiving impacts of language on health and health care utilization. Clinical practice recommendations for health care professionals working with individuals with frailty include: (1) maintaining a holistic view of frailty that extends beyond physical function to include psychosocial and environmental constructs, (2) using person-first language, and (3) using a strengths-based approach to discuss aspects of frailty.

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“…The FRAIL predicts poor outcomes to a similar extent as the Fried et al (5) questionnaire and the Rockwood frailty screens (9). Becoming frail marks a major downhill slide in older persons and if identified early before the onset of disability, frailty is potentially reversible (10,11).…”

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confidence: 86%