Older people living with frailty value their autonomy and their functioning when they receive acute care in hospital. Research found that they want to feel in control of their healthcare, and to feel safe when they go home.

Hospitals typically use waiting times and survival rates to judge the quality of care they provide. This study carried out interviews with older people living with frailty who had been in an emergency department. It found that these typical quality metrics did not fully capture the health outcomes that were most important to this group.  

People with frailty are vulnerable to poor outcomes when a health crisis occurs. Knowing what matters most to them will help improve the quality of care they receive when attending an emergency department.

A series of interviews in Leicester found that patients’ main goals were to maintain autonomy and functioning. Autonomy involved being well-informed and in control, and feeling sufficiently secure at home. Functioning meant being able to manage daily care routines, not to be a burden on others, and relief from being unwell. Some patients wanted full independence in decision-making; others wanted family members to help make decisions. Some wanted to know more clinical details than others.

Increased awareness of the impact of frailty on people’s wishes could help healthcare professionals support them in a meaningful way. The researchers call for shared decision making to tailor care to each person. This work is part of a larger project looking at how to best measure person-centred acute healthcare for those with frailty.