Health despite frailty: Exploring influences on frail older adults' experiences of health

Ebrahimi, Zahra; Wilhelmson, Katarina; Eklund, Kajsa; Moore, Crystal Dea; Jakobsson, Annika

doi:10.1016/j.gerinurse.2013.04.008

Cited by 52 publications

(63 citation statements)

References 33 publications

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“…Here we present examples coming from sixteen papers, of how people aim to keep frailty at a distance or control it, for example, using strategies and behaviour to help cope with conditions which cannot be changed in themselves, changing their relationship with their conditions, indicating resilience [9,37,41,42,44,48,50,51,52,59,60,63,64,66,69,73]. …”

Section: Resultsmentioning

confidence: 99%

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Stakeholders’ views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

et al. 2017

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Frailty is a common condition in older age and is a public health concern which requires integrated care and involves different stakeholders. This meta-synthesis focuses on experiences, understanding, and attitudes towards screening, care, intervention and prevention for frailty across frail and healthy older persons, caregivers, health and social care practitioners. Studies published since 2001 were identified through search of electronic databases; 81 eligible papers were identified and read in full, and 45 papers were finally included and synthesized. The synthesis was conducted with a meta-ethnographic approach. We identified four key themes: Uncertainty about malleability of frailty; Strategies to prevent or to respond to frailty; Capacity to care and person and family-centred service provision; Power and choice. A bottom-up approach which emphasises and works in synchrony with frail older people's and their families' values, goals, resources and optimisation strategies is necessary. A greater employment of psychological skills, enhancing communication abilities and tools to overcome disempowering attitudes should inform care organisation, resulting in more efficient and satisfactory use of services. Public health communication about prevention and management of frailty should be founded on a paradigm of resilience, balanced acceptance, and coping. Addressing stakeholders’ views about the preventability of frailty was seen as a salient need.

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Section: Resultsmentioning

confidence: 99%

“…Adaptive responses can assume the form of affirming “health despite frailty” [42] with evidence of maintained perceived balance and resilience in the context of physical impacts:…”

Section: Resultsmentioning

confidence: 99%

Stakeholders’ views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

et al. 2017

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“…This understanding of frailty as constitutional, also argued by philosophers such as Ricoeur (1992) and Levinas (2006), has lately been gaining more focus in gerontology (Björnsdóttir, Ceci, & Purkis, 2015; van der Meide, Olthuis, & Leget, 2015; Nortvedt, 2003). Furthermore, frailty understood as a condition for relational engagement (Ceci, Ttir, Björnsdóttir, & Purkis, 2013; Katz & Shotter, 1996; Kulick & Rydström, 2016) has been progressively explored in the literature regarding older adults living in NHs (Ebrahimi, Wilhelmson, Eklund, Dea Moore, & Jakobsson, 2013). Person‐centered care research for frail older adults highlights as pivotal this relational dimension (McCormack, 2003, 2004; Nolan, Davies, Brown, Keady, & Nolan, 2004).…”

Section: Introductionmentioning

confidence: 99%

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

et al. 2017

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This study focuses on influence that older adults, living in nursing homes, have over everyday activities. Everyday activities are key to sustain a sense of stability, predictability, and enjoyment in the local world of people's everyday and therefore a critical dimension of the person‐centeredness framework applied within gerontology. This narrative ethnographic study aimed to shed light on how influence can be situated contextually, and how it can emerge through activities as well as how it is negotiated in everyday by frail older adults living in a nursing home. Residents, staff members, and significant others from one nursing home in an urban area of Sweden participated in this study. Data were gathered through fieldwork, including participant observation and formal and informal conversations during a period of 6 months. Data were analyzed through a narrative interpretative approach. The findings are presented in narrative form as exemplars. The exemplars—Craquelures as justification, Seeking a place for other life worlds and An almost perfect trip—reveal a gap between the client‐centeredness framework and lived experiences regarding older adults’ influence in everyday activities. The role of everyday activities in the context of frailty is discussed in terms of ethical and responsive engagement, and implications for health‐care practices are considered.

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“…It might be because it is more difficult for older people to detect and interpret symptoms (Riegel et al 2010), or that older people might fail to recognize and report significance changes in health status as a result of the new signs or symptoms being covered by other chronic diseases (Bender 1992). Older people with symptoms that are well managed are more likely to feel safe, in control and to experience good health (Ebrahimi et al 2013). A challenge for the health care system is to organize and provide care that is individualized and that focuses on the whole person rather than on separate health issues (McEvoy and Duffy 2008).…”

Section: Introductionmentioning

confidence: 99%

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

Eckerblad

Theander

Ekdahl

et al. 2015

Applied Nursing Research

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Context. Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life.Objectives. The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.Method. A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden. The participants were 79-89 years old with a mean of 12 symptoms per person. Data were analyzed using content analyses.Results. The experience of living with a high symptom burden revealed the overall theme, "To adjust and endure" and three sub-themes. The first subtheme was "To feel inadequate and limited". Participants reported they no longer had the capacity or the ability to manage and they felt limited and isolated from friends or family. The second sub-theme was "To feel dependent". This was a new and inconvenient experience, the burden they put on others caused a feeling of guilt. The final sub-theme was "To feel dejected". The strength to manage and control their conditions was gone, the only thing left to do was to sit or lie down and wait for it all to pass.Conclusion. This study highlights the importance of a holistic approach when taking care of older people with multi-morbidity. This approach should employ a broad symptom assessment to reveal diseases and conditions that it is possible to treat or improve.

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Health despite frailty: Exploring influences on frail older adults' experiences of health

Cited by 52 publications

References 33 publications

Stakeholders’ views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

Stakeholders’ views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

Influencing everyday activities in a nursing home setting: A call for ethical and responsive engagement

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

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