Older Adults Perception of Frailty

Background/Purpose: Clinically, the term frailty is a state of decreased physiological reserve. Clinicians diagnose frailty as an opportunity to identify and mitigate risks. In contrast, many older adults associate the term frailty with negative stereotypes of aging. We aimed to describe older adults' perceptions of the clinical concept of frailty and its usefulness when discussing their health.

Method: Older adults 65 years and older were recruited from two outpatient clinics, and a geriatric inpatient rehabilitation unit from Sept 2018 to June 2019. Semi-structured interviews were conducted to explore interviewees' perceptions of the term and the clinical concept of frailty. The Edmonton Frailty Scale (EFS) was performed on each participant. Using interpretive description, analysis was done through line-by-line coding and then data was explored for patterns based on frailty status and other demographic factors.

Results: A total of 23 individuals were interviewed (66 to 90 years old). Physical and/or cognitive decline, decreased function, poor mood, negative mindsets were associated with frailty. Most participants indicated that they would have a negative emotional reaction if told they were frail. Some participants saw no utility in the frailty term, while others saw it could initiate health improvement behaviours. In contrast, if a clinician disclosed, they were in a state of increased risks, more participants associated this with a medical diagnosis and had a neutral emotional reaction. Many participants saw this disclosure as an opportunity to discuss mitigating strategies.

Discussion: The older adults' perceptions of frailty were complex. The frailty term was seen as stigmatizing, but the concept of increased vulnerability was more commonly seen as a medical condition.

Conclusion: Clinical communication around frailty may be more acceptable to older adults if structured around the concept of increased vulnerability.