Using the clinical term “frailty” can provoke a strongly negative reaction from older patients, because of its associations with loss of independence and end of life, a report has warned.
It found older people preferred to describe their needs in more straightforward terms, such as starting to struggle with things or being worried about their health.
The priority for those interviewed for the report was staying independent and they saw “frailty” as an irreversible state, entered into at the end of life and linked with severe lifestyle limitations.
“Health and care services need to re-evaluate their use of the word ‘frailty’”
The view contrasts starkly with the clinical concept of frailty as a condition that needs to be identified and diagnosed so it may be managed with appropriate support.
Older people were felt to be so put off by the words “frail” and “frailty” that their use might deter them from seeking appropriate support should they actually experience the symptoms of frailty.
In many cases, those interviewed described the moment they needed to ask for help as “a major turning point” in their sense of wellbeing, and a real threat to their independence.
The research, commissioned by Age UK and the British Geriatrics Society, recommended avoiding the term “frailty” or “frail” when in dialogue with older people.
Instead, it suggested using language that promoted what can be achieved through a person’s healthcare, rather than assuming nothing can be done.
“The take home message here, though, has to be that no patient, no matter how old or dependent, is beyond help”
However, the report – titled Frailty: Language and Perceptions (see PDF top-right) – highlighted the vital importance of health professionals working with older people to signpost them to appropriate services.
Dr Adam Gordon from the British Geriatrics Society noted that frailty had been “embraced as a concept” by parts of the NHS to signpost multi-disciplinary services known to deliver better health for older people in later life.
“If the patients we are seeking to help are put off by the very use of the word frail, then perhaps we’ll need to reconsider how we refer to such initiatives,” he said.
“The take home message here, though, has to be that no patient, no matter how old or dependent, is beyond help,” he said. “We have to find the right words to help our patients recognise this.”
Caroline Abrahams, charity director at Age UK, also suggested that healthcare services might need to “re-evaluate” their use of the word frailty.
“Frailty is all at once a medical term, an adjective, and a noun, but as the research shows for many older people it feels like a judgement,” she said.
“It would be better to focus on the factors that may be underlying someone’s frailty and find solutions that help,” she said. “This should also be reflected in how all professionals communicate.”