Professional home care providers' conceptualisations of frailty in the context of home care: A focus group study

• Published in: International journal of older people nursing 2023-01, Vol.18 (1), p.e12511-n/a
• Main Authors: Voie, Kristin S., Blix, Bodil H., Helgesen, Ann Karin, Larsen, Toril Agnete, Mæhre, Kjersti Sunde
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; care; Concept Formation; Elder care; Environmental aspects; focus group discussions; Focus Groups; Frail; Frail Elderly; Frailty; home care professionals; Home Care Services; Home health care; Humans; Meaning; Medical personnel; Nurses; Older people; Original; Professionals; Qualitative research
• ISSN: 1748-3735; 1748-3743; 1748-3743
• DOI: 10.1111/opn.12511

Background In Norway, as in many other countries, more people receive health and care services in their homes than before. Home care professionals provide care and support to people with a range of health and care needs. Older home care service users are sometimes referred to as ‘frail’, but the terms ‘frail’ and ‘frailty’ have different meanings in different contexts, and little is known about the meaning ascribed to the terms in the context of home care services. Home care services are crucial for many older persons who have health challenges, and how home care professionals conceptualise frailty might shape clinical encounters. Objectives The purpose of this study is to explore how home care professionals conceptualised frailty in the context of home care. Methods We conducted four focus group discussions with 14 home care professionals who worked in municipal home care in northern Norway and analysed the data using thematic analysis. Results Our analysis resulted in five themes: ‘“Frail” – a term which is too imprecise to be useful’, ‘Frailty as a consequence of ageing’, ‘Frailty as lack of engagement and possibilities for engagement’, ‘Frailty as a contextual phenomenon’ and ‘Frailty as potentially affected by care’. The home care professionals conceptualised frailty as an individual trait but also as resulting from the interplay between individual and environmental factors. Moreover, their conceptualisations of frailty represented a continuum between frailty as related to prevention and management (‘cure’) and frailty as related to ageing as natural decline (‘care’). Conclusion The home care professionals conceptualised frailty diversely, as moving along a continuum between cure and care. Diverse conceptualisations of frailty might be necessary if nurses are to meet the changing and varying care needs of older persons who live in their own homes and need health and care services.