Addressing what matters to frail older people and their informal carers in primary care based clinical encounters and contacts
Working with frail older adults is an increasingly important aspect of primary care based practice, and one that requires a sensitive, skilled workforce. The challenges for health care professionals in recognising frailty among older people are well known alongside the importance of advance care planning, clinician-patient communication and providing appropriate palliative care. To date, communication about frailty with patients and families has received little attention. Anecdotal evidence suggests that some clinicians are unsure how to tackle this subject, but whether frail older adults and their caregivers perceive communication with their professional carers to be a particular problem, is unknown.
In this study, we will work with patients, their informal carers, and health professionals to:
1. explore the perceptions and experiences of frail older people, and their informal carers, of clinical encounters with primary care based practitioners and identify which aspects of the clinical encounter matter most;
2. understand primary care based practitioners’ perceptions of the priorities and main challenges of consultations with frail older adults and their informal carers;
3. identify priority areas for practice development to meet the needs of frail older people and their informal carers and support health professionals; and
4. explore the form and content of information or training resources that would be acceptable, accessible and useful to primary care based practitioners
There are three stages to this study:
• Stage 1: Systematic scoping reviews of the literature to ‘map’ relevant literature addressing (i) what matters to frail older people, and their informal carers, in their clinical encounters with primary care based practitioners and (ii) understand the priorities and challenges for primary care based practitioners when consulting with frail older people and their informal carers (addresses aims 1 and 2)
• Stage 2: Interviews and/or focus groups to explore perceptions and experiences of clinical contacts with (i) frail older people, and their informal carers and (ii) primary care based practitioners (addresses aims 1 and 2)
• Stage 3: Workshop with primary care-based practitioners to feedback findings from Stage 1 and 2 and areas that we have identified as priority areas for practice development to meet the needs of frail older people and their carers. We will use the workshop to (i) gather the response of practitioners to these findings, (ii) gather data on what support health professionals consider they need to better meet these needs and (iii) to gather ideas of what resources might be most useful for practitioners to promote best practice in care frail older people in primary care.
These findings will be used to inform future development of information or training resources that would be acceptable, accessible and useful to primary care based practitioners. This study will provide a platform for future applications for financial support to develop these resources and consider evaluating their effectiveness.