Lived Versus Perceived Frailty and Falls in Older Adults Using an English Regional Ambulance Service: A Descriptive Phenomenological Study

Abstract

ObjectiveFrailty is of increasing importance for healthcare systems as well as the personalised care agenda.  Despite the evolving body of research exploring frailty and falls in the ambulance setting, the voices of frail older adults who use ambulance services, are seldom heard.  Through first-hand accounts of older adults with frailty and falls, this study set out to describe and contrast objective versus perceived frailty.MethodsA descriptive phenomenological study involving eight participants with frailty who used a regional English National Health Service ambulance trust after a fall, conducted between July 2022-February 2023.    ResultsAccounts from older adults highlight different perceptions of frailty and attitudes towards ageing.  Frailty and falls were experienced through varying perceptions of identity and Self, underpinned by acceptance, or otherwise, of an altered sense of embodiment, and a life with limits.    ConclusionOlder adults generally held negative perceptions of frailty, falls and ageing, but also challenged the negative terms frequently used to describe frailty, suggesting some frail older adults remain positive and still value life.  Paramedics are likely to require further training and support to manage patients with frailty effectively and improve patient experience. InnovationThese data add a new dimension to our understating of frailty.

Note:
Funding declaration: The study was funded by Mangar UK, but they had no involvement in the design or implementation of this study, or in the writing of this manuscript.

Conflict of Interests: None.

Ethics statement: Ethics approval for this study was received Fulham Research Ethics Committee [22/PR/0620] and the Health Research Authority. All participants provided written informed consent prior to interview.

Keywords: Frailty, falls, ambulance, phenomenology