“There’s More to Frail than That”: Older New Zealanders and Health Professionals Talk about Frailty

Abstract

ere is general agreement that frailty is common and important in later life, but there is less agreement about what frailty is. Little is known about the extent to which practicing health professionals and older people hold a mutual understanding of frailty. Focus groups were held to engage older people and health professionals in discussion about what made them think that someone was frail. Eighteen older people took part across three focus groups, and se'venteen health professionals took part across another three focus groups. Both the health professionals and the older people talked about the experience of frailty as an interplay of physical, psychological, and social dimensions. Older people with frailty were seen as needing help and being vulnerable to adverse outcomes, but accepting help was positioned by older people as an adaptive choice. e experience of frailty was described as being mediated by the individual's psychological mindset, highlighting the importance of approaches that recognise strengths and resilience. A broader and more balanced understanding of frailty may help create more rounded and appropriate approaches to assessment and management.

Definitions of Frailty in Qualitative Research: A Qualitative Systematic Review

“…Tests for cognitive function and mood were also used in some of the more contemporary articles. Increasingly, opinions about frailty in the scientific literature indicate that focusing exclusively on physical frailty hinders a full understanding of frailty and its impact on the individual [68]. 4.7.…”

“…Nonstigmatizing synonyms for frailty are needed to facilitate communication and recruitment in research contexts, since the term frailty may offend, frighten, or turn away potential participants. Several strategies are recommended for communicating with frail individuals that include avoidance of the term "frailty" and using language that promotes independence, enablement, and resilience [68,72]. e concept of intrinsic capacity as posited by the World Health Organization is central to the prevention and mitigation of frailty; dialogue that frames frailty using perspectives of empowerment, capacity, and capability may foster resilience and resistance to frailty [1].…”

“…Public service messaging and health education should be tailored for subgroups based on gender, since the frailty experience among men and women differs [47]. Qualitative research can elaborate on these issues and uncover how resilience mediates frailty and identify terminology to incorporate a broader and more balanced understanding of frailty [68,72]. e purpose of this review was not to discern or endorse a definition of frailty, but to represent how it is defined in qualitative research for participant selection inclusion criteria.…”

What Is Frailty? Perspectives from Chinese Clinicians and Older Immigrants in New Zealand

“…The three main themes emerged from our qualitative data are consistent with this multi-dimensional concept of frailty reported in both Chinese and non-Chinese cultures, including New Zealand's Europeans and indigenous people. (Dury et al, 2018;Gee et al, 2019;Gee et al, in press;Puts et al, 2009, Teo et al, 2019. A previous systematic review, where majority of the studies were with Europeans, North Americans and Latin Americans, found the main factors associated with frailty are age, female gender, black race/color, schooling, income, cardiovascular diseases, number of comorbidities/diseases, functional incapacity, poor self-rated health, depressive symptoms, cognitive function, body mass index, smoking, and alcohol use (Mello et al 2014).…”

Toward improved homecare of frail older adults: A focus group study synthesizing patient and caregiver perspectives

“…Home care recipients with frailty incur greater annual health care costs compared with nonfrail age‐matched individuals, driven by a greater magnitude of health care utilization 13,14 . Determining what makes a home appropriate for aging requires practical knowledge of frailty management and adverse outcome prevention, all while meeting individual needs 13‐15 …”