Abstract
Introduction
The term ‘frailty’ is increasingly being used in clinical practice. NHS services established to assess frail older people are described using various names including ‘Frailty Unit’ (FU). Little is known about patient’s self-perception on being frail and their views on the use of these terms and nomenclatures. Following the development of a new FU in the Emergency Quadrant of our DGH, this study was undertaken to assess how elderly in-patients in the unit perceive ‘frailty’ as a concept. Their views on the nomenclature of the unit and the service were also evaluated.
Methods
A semi-structured qualitative interview was conducted on in-patients in the FU after medical optimisation of their condition and prior to discharge. Those with communication barriers and lacking mental capacity to participate were excluded. Frailty severity was assessed using the Edmonton Frail Scale (EFS).
Results
20 patients were interviewed (mean age 84 years; range 75-98; 65% females). EFS classified patients (n) as ‘not frail’ (2), ‘vulnerable’ (7), ‘mild frailty’ (4), ‘moderate frailty’ (4) and ‘severe frailty’ (3). There was no correlation between age and presence of frailty on EFS. Only 5 (25%) considered themselves as frail compared to 55% deemed to be frail on EFS. Only 28.6% with moderate to severe frailty on EFS considered themselves as frail. 40% disapproved the nomenclature ‘Frailty Unit’ due to its negative connotation despite overall satisfaction with the service. Majority (85%) were happy to discuss the concept of frailty and strategies to manage it.
Conclusion
Identification of frailty on EFS may not necessarily correlate with the patient’s self-perception of being frail. Though the term frailty and frailty unit may be perceived as negative by some patients, this did not correlate with their service experience. Clinicians must take the opportunity to discuss the concept of frailty openly with patients including management strategies.