Frailty identification and management by dietitians: A qualitative study

Frailty is common in later life and chronic conditions. It is associated with reduced quality of life, and increased disability and mortality. The large overlap with malnutrition means that dietitians can play a key role in frailty identification and management, however, few studies have explored their experiences of this. We aimed to explore the perceptions of dietitians on the identification and management of frailty in older people.

We carried out virtual interviews and focus groups with 13 United Kingdom registered dietitians working with older people in a range of acute and community settings. Data were analysed using reflexive thematic analysis.

Dietitians felt they had an important role in managing the nutritional aspects of frailty and were confident in this. They reported a need to engage and educate patients and carers to overcome misconceptions about later life nutrition and weight loss. Dietitians were often part of a multidisciplinary team, which was considered a holistic approach that facilitated interprofessional learning. However, they reported that other healthcare professionals had variable understanding of their frailty role. Dietitians were unsure regarding their role in frailty identification and lacked confidence and experience in using assessment tools. They felt there were few formal frailty training opportunities available and that they needed to actively seek these out.

Guidance needs to be developed to strengthen dietitians' role in frailty care and provide clarity regarding frailty identification. More formal training opportunities need to be provided by key regulating organisations.