Making sense of frailty: An ethnographic study of the experience of older people living with complex health problems.
Julie Kathryn Skilbeck, Antony Arthur, Jane Seymour
PMID 28990309WHAT IT FOUND
Ten frail older people described fluctuating health and fear of falling, yet kept going by adjusting routines, pacing tasks and dropping non-essential ones.
Their accounts show daily living can become precarious even when impairment is known.
Key findings
01Most participants experienced health as a constant gradual decline in ability to manage daily living, while a few had periods of stability.
02Maintaining daily routines helped participants preserve a sense of self as independent people, and they changed tasks when needed, such as eating on their lap.
03Fear and uncertainty appeared in specific episodes, such as Martha's fear of falling after a broken leg and Christine's distress after severe chest pain.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
Only ten older people were studied, all living alone and aged 75 or over, from one community matron service in one city, so the themes cannot be taken as general evidence for all frail older people. Frailty was determined subjectively by the community matron team, not by an objective measurement. People who could not communicate easily, such as those living with dementia or stroke, were not included. Recruitment depended on community matrons, who acted as gatekeepers, and some introduced the researcher as a colleague, which may have affected consent. The researcher was a nurse educator with a focus on ageing and palliative care, so her interpretation may have shaped the themes.
Declared interests
No potential conflicts of interest were reported.
The easy way to misread this
Do not conclude that asking about routines improves outcomes. The study describes what ten older people said and did; it did not test any intervention, and participants were selected from one community matron service.