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The frail individual: uncovering the complexities in care and support across three common distinct settings.

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Title: The frail individual: uncovering the complexities in care and support across three common distinct settings.
Authors: Sunkersing, David James
Item Type: Thesis or dissertation
Abstract: Introduction By 2050, an estimated 2 billion people will be 65 years or older, bringing significant implications for health and social care. One implication – frailty – will affect patients, staff and healthcare settings. There is a need for improved recognition and care and support of frail individuals. Aims This thesis aims to uncover the complexities in the care and support of frail individuals across three distinct settings. A high-level study investigated the non-acute care setting, followed by investigating three distinct settings: community, acute hospital care and nursing homes. Methods A mixed-methods approach was used. Following a literature review, a survey (questionnaire) helped better understand ‘assessments for frailty’ used in the non-acute care setting. In the community setting, semi-structured interviews were undertaken with patients and healthcare professionals, using a participatory approach. In the acute care setting, a cross-sectional study of frail patients was conducted using patient data records. Regarding nursing homes, an online survey (questionnaire) helped investigate how frailty is assessed. Results Frailty is often understood and assessed as physical and mental health deficits. The perceptions of healthcare professionals and frail individuals regarding frail care and support networks overlap, but are distinct with different emphases. In acute care, variation in frail individuals’ living arrangement pre-admission and post-discharge was found, with a high proportion being discharged to a nursing home. Great variation in assessing for frailty was found in nursing homes. Conclusion Highlighted is the importance of family and friends in the care and support of frail individuals. Many hospital patients were discharged to settings with enhanced care and support availability, demonstrating the importance of care and support. ‘Assessing for frailty’ may require review to ensure holistic consideration of individuals and better frailty recognition. This may help improve the care and support of a frail individual and outcomes.
Content Version: Open Access
Issue Date: Oct-2020
Date Awarded: Feb-2021
URI: http://hdl.handle.net/10044/1/101599
DOI: https://doi.org/10.25560/101599
Copyright Statement: Creative Commons Attribution NonCommercial Licence
Supervisor: Bell, Derek
Reed, Julie
Sponsor/Funder: National Institute for Health Research (NIHR)
Department: Department of Medicine
Publisher: Imperial College London
Qualification Level: Doctoral
Qualification Name: Doctor of Philosophy (PhD)
Appears in Collections:Department of Metabolism, Digestion and Reproduction PhD Theses



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