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Becoming frail: a major turning point in patients' life course
Emile Escourrou1, Mickael Herault1, Samy Gdoura1
1Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.
Background:
The frailty concept requires that practices should be adapted to meet the challenge of dependence. The GP is in the front line of management of frail elderly patients.
Objectives:
To explore the perception of elderly persons of the term and concept of frailty and to understand their perception of the risk of loss of independence.
Methods:
Two qualitative studies by individual interviews in the homes of elderly persons identified as potentially frail by their GP, or diagnosed as frail and at risk of loss of independence. The sampling was theoretical. The analysis was carried out using an inductive approach following the phases of thematic analysis. The researchers used triangulation and collection was concluded when theoretical saturation had been reached.
Results:
The concept of frailty was seen as forming an integral part of physiological ageing and appeared to be irreversible. The term of frailty had a negative connotation. The physical, cognitive and psychological components of frailty were present in the participants' discourse. Nutritional and sensory components were less present. Frailty due to inappropriate medication was not cited. Seven risk factors for loss of independence were identified: social isolation, poor physical health, poor mental health, loss of mobility, unsuitable living conditions, unsuitable environment, and low resources.
Conclusions:
Becoming frail is a major turning point in patients' life course. Coordinated multiprofessional management that takes account of patients' perceptions could help in negotiating a feasible care plan adapted to the patient's needs.