Constructs of a ‘frail identity’ within a Day Hospital setting.

Authors: Cox, C., Ellis-Hill, C., Board, M. and Vassallo, M.

Conference: International Conference of frailty and Sarcopenia Research 27th Feb – 4th March )

Dates: 27 February-4 March 2018


Background In the UK 50% of people over 85 years live with frailty. Clinically operational definitions of frailty have been debated and in wider society frailty is seen as a negative term. Older people often do not wish to be defined as frail and so this can discourage people from accessing frailty services (Age UK and BGS, 2015) Objectives This study aims to understand how peoples sense of self and identity in relation to frailty is created in a Day Hospital which is rated highly by patients. Through exploration of their socio-cultural experiences of care we aim to determine how identity in frail older people is understood and constructed, and how key positive processes could be transferred to support future best clinical practice in other health care settings. Methods Approximately 84 hours of participant observer data were collected from a medium sized NHS Day Hospital. Observations and interviews were made with patients, relatives/carers, staff and volunteers in order to gain insight into the discursive and behavioural processes which contribute to the identities of frail older people within the day hospital. Results The study is ongoing. Initial themes identified relate to a) the work force feeling valued at all grades b) colleague compassion within the team c) patients experiencing many losses d) recognition of the time needed to adapt to new realities rather then expecting a quick recovery and e) small rehabilitation gains being seen and supported by staff, patients and carers. Conclusion Developing and delivering services for frailty is challenging. Patients with frailty need time to adapt to their changing identities. Managing patient expectations, and supporting a positive sense of self for both patients and staff is key to continued therapeutic engagement.

Source: Manual