A Feasibility Study of an Investigation into the Factors of Frailty

Abstract

The population of the World is living longer, making health and social care provision for older people a critical issue. Frail people are described by means of their limited functional reserve, or failure to integrate responses in the face of stress when confronted with minor health issues (Rockwood & Hubbard, 2004). A universally acceptable clinical definition of frailty has not been established to date: remaining elusive and is in need of description and analysis (Karunananthan et al, 2009).This feasibility study explored the ability to examine the physical, social and cognitive factors of frailty in two cohorts (non-frail and frail) over the age of 18 years within a South Wales community to enhance existing knowledge. The study used a two phase explanatory mixed methods design: follow-up explanations model. Case control method was used to examine 30 non-frail and 30 frail people’s documented health and social care data to inform the design of phase two. This involved a single qualitative, idiographic case study, semi-structured interview using Interpretive Phenomenological Analysis (IPA) developing an understanding of the lived experience of frailty.The results: phase one provided evidence that most of the physiological health care components of frailty were not statistically significant and was shared between non-frail and frail people alike. However, all social care determinants were statistically significant except wheelchair use. Phase two developed five themes; life purpose and support, trust and faith, coping with vacillation, acquiescence of fate, and consequential incident. The major finding of this study was that future frailty tools need greater specificity and sensitivity, and that frailty was experienced as day to day coping with physiological and psychological stressors. In order to achieve self efficacy the frail person needs intrinsic locus of control to combat their day to day challenges. The disability blue badge scheme is an area where future annual risk assessment could be possible when integrated into the application process