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New horizons in frailty: the contingent, the existential and the clinical

Pickard, S., Cluley, V., Danely, J., Laceulle, H., Leon-Salas, J., Vanhoutte, B. and Romero-Ortuno, R. (2019). New horizons in frailty: the contingent, the existential and the clinical. Age and Ageing, 48(4), pp. 466-471. doi: 10.1093/ageing/afz032

Abstract

In the past decade, frailty research has focused on refinement of biomedical tools and operationalisations, potentially introducing a reductionist approach. This article suggests that a new horizon in frailty lies in a more holistic approach to health and illness in old age. This would build on approaches that view healthy ageing in terms of functionality, in the sense of intrinsic capacity in interplay with social environment, whilst also emphasising positive attributes. Within this framework, frailty is conceptualised as originating as much in the social as in the biological domain; as co-existing with positive attributes and resilience, and as situated on a continuum with health and illness. Relatedly, social science-based studies involving interviews with, and observations of, frail, older people indicate that the social and biographical context in which frailty arises might be more impactful on the subsequent frailty trajectory than the health crisis which precipitates it. For these reasons, the article suggests that interpretive methodologies, derived from the social sciences and humanities, will be of particular use to the geriatrician in understanding health, illness and frailty from the perspective of the older person. These may be included in a toolkit with the purpose of identifying how biological and social factors jointly underpin the fluctuations of frailty and in designing interventions accordingly. Such an approach will bring clinical approaches closer to the views and experiences of older people who live with frailty, as well as to the holistic traditions of geriatric medicine itself.

Publication Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record Pickard, S., Cluley, V., Danely, J., Laceulle, H., Leon-Salas, J., Vanhoutte, B. and Romero-Ortuno, R. (2019). New horizons in frailty: the contingent, the existential and the clinical. Age and Ageing, 48(4), pp. 466-471, is available online at: https://doi.org/10.1093/ageing/afz032.
Publisher Keywords: frailty, lived experience, social science,first-person perspective, healthy ageing
Departments: Cass Business School > Management
URI: https://openaccess.city.ac.uk/id/eprint/22455
[img] Text - Accepted Version
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