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BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Detecting frail, older adults and identifying their strengths: results of a mixed-methods study

Authors: Sarah Dury, Eva Dierckx, Anne van der Vorst, Michaël Van der Elst, Bram Fret, Daan Duppen, Lieve Hoeyberghs, Ellen De Roeck, Deborah Lambotte, An-Sofie Smetcoren, Jos Schols, Gertrudis Kempen, G.A. Rixt Zijlstra, Jan De Lepeleire, Birgitte Schoenmakers, Dominique Verté, Nico De Witte, Tinie Kardol, Peter Paul De Deyn, Sebastiaan Engelborghs, Liesbeth De Donder

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

The debate on frailty in later life focuses primarily on deficits and their associations with adverse (health) outcomes. In addition to deficits, it may also be important to consider the abilities and resources of older adults. This study was designed to gain insights into the lived experiences of frailty among older adults to determine which strengths can balance the deficits that affect frailty.

Methods

Data from 121 potentially frail community-dwelling older adults in Flemish-speaking Region of Belgium and Brussels were collected using a mixed-methods approach. Quantitative data were collected using the Comprehensive Frailty Assessment Instrument (CFAI), Montreal Cognitive Assessment (MoCA), and numeric rating scales (NRS) for quality of life (QoL), care and support, meaning in life, and mastery. Bivariate analyses, paired samples t-tests and means were performed. Qualitative data on experiences of frailty, frailty balance, QoL, care and support, meaning in life, and mastery were collected using semi-structured interviews. Interviews were subjected to thematic content analysis.

Results

The “no to mild frailty” group had higher QoL, care and support, meaning in life, and mastery scores than the “severe frailty” group. Nevertheless, qualitative results indicate that, despite being classified as frail, many older adults experienced high levels of QoL, care and support, meaning in life, and mastery. Respondents mentioned multiple balancing factors for frailty, comprising individual-level circumstances (e.g., personality traits, coping strategies, resilience), environmental influences (e.g., caregivers, neighborhood, social participation), and macro-level features (e.g., health literacy, adequate financial compensation). Respondents also highlighted that life changes affected their frailty balance, including changes in health, finances, personal relationships, and living situation.

Conclusion

The findings indicate that frailty among older individuals can be considered as a dynamic state and, regardless of frailty, balancing factors are important in maintaining a good QoL. The study investigated not only the deficits, but also the abilities, and resources of frail, older adults. Public policymakers and healthcare organizations are encouraged to include these abilities, supplementary or even complementary to the usual focus on deficits.
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Metadata
Title
Detecting frail, older adults and identifying their strengths: results of a mixed-methods study
Authors
Sarah Dury
Eva Dierckx
Anne van der Vorst
Michaël Van der Elst
Bram Fret
Daan Duppen
Lieve Hoeyberghs
Ellen De Roeck
Deborah Lambotte
An-Sofie Smetcoren
Jos Schols
Gertrudis Kempen
G.A. Rixt Zijlstra
Jan De Lepeleire
Birgitte Schoenmakers
Dominique Verté
Nico De Witte
Tinie Kardol
Peter Paul De Deyn
Sebastiaan Engelborghs
Liesbeth De Donder
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5088-3

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