The increasing operationalisation of frailty including in primary care brings with it a risk of oversimplifying diagnostic processes and inadvertently barring access to comprehensive geriatric assessment services. The emphasis on measurement tools, despite updated guidance to the contrary, can also undermine the importance of clinical judgement, meaning that noncontractual evidence-based opportunities for medical optimisation (e.g. exercise promotion, nutrition optimisation) as well as appropriate access to social supports may be missed. Another significant consequence is to open up an ever-widening gap between clinical approaches and lived experience, including overlooking strengths and resources in problembased
approach and inadvertently alienating the very group it is trying to assist. This article argues that the next horizon in frailty should not be to continue to refine its operationalisations but rather to reconnect with more holistic approaches to health and illness in old age, which are more in tune with the tradition of geriatric medicine. Building on recent trends to shift conceptualisation of health and illness in old age, this project would benefit from sociological and humanities-based approaches that foreground older people’s lived
experience using theoretically informed description focused on a first-person perspective. In reconfiguring what we think frailty is, such a shift will bring us closer to the views and experience of older people who live with frailty. We see a brighter horizon for frailty in that direction.
Pickard, SusanCluley, VictoriaDanely, Jason
Laceulle, HanneLeon-Salas, JorgeVanhoutte, BramRomero-Ortuno, Roman
Faculty of Humanities and Social Sciences\Department of Social Sciences
Year of publication: 2019Date of RADAR deposit: 2019-03-12