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Frailty is a geriatric syndrome which can be reversible or less severe through appropriate nutritional interventions. In the present study, to test the efficiency of individualized nutritional intervention was conducted a comprehensive assessment of the nutritional status of frail older adults and evaluation of the effect of nutritional intervention on the nutritional status of pre-frail older patients.

Frail older adults (n = 43; mean age 84.6 ± 6.4 years old; 81.4% women) had nutritional status assessed using nutritional anthropometry, body composition, and food frequency questionnaire. Pre-frail patients (n = 16; mean age 68.4 ± 5.5 years old; 81.3% women) for eight weeks were consuming 1.0 g protein/kg BW/day. Robust older adults formed a control group (n = 29; mean age 69.3 ± 5.3 years old; 82.8% women).

Frail older adults had weight and muscle mass loss, and their diet variety was sufficient. After the intervention, pre-frail patients increased their protein consumption by 25.8% (P = 0.002). An increase in lean body mass (+1.0 kg), skeletal muscle mass (+0.3 kg) and improvement in physical performance was also observed.

An individual diet for pre-frail older adults can reverse weight loss and increase lean body mass, furthermore preventing or delaying the development of frailty syndrome. Moreover, increased protein consumption improves physical performance of pre-frail older adults.

The purpose of this paper is to explore the association between level of physical activity (PA) and perception of quality of life (QOL) and physical health in frail and non-frail older adults.

Volunteer participants in this quantitative cross-sectional study were a convenience sample of 236 independent residents (120 frail, 116 non-frail) in an assisted living facility in Israel. Frailty was measured by Fried et al.’s phenotype; QOL and physical health were measured using the World Health Organization Quality of Life Instruments (WHOQOL-BREF) questionnaire. PA level was ascertained from attendance lists completed by exercise class instructors in each class during the eight-week study.

Frail older adults who engaged in regular PA (at least 2.5 h/week) reported the same physical health as non-frail older individuals performing a similar level.

Unsupervised PA performed independently was not taken into consideration; exercise class attendance may be a less reliable criterion of PA than collection of objective data, i.e. calories burned; participants were selected from an economically homogeneous population of a specific assisted living facility with easy access to a variety of PA.

The level of PA performed by frail older adults impacts their perceived QOL and physical health. The logs were an incentive to attend PA classes.

A minimum of 2.5 h a week of regular PA can be a protective factor that improves perceived QOL and physical health in frail older adults.

In the context of early detection of frail older people, prior research found several risk factors of multidimensional frailty. The current study aims to validate these risk factors.

Two data sets, Belgian Ageing Studies and Detection, Support and Care for older people: Prevention and Empowerment (BAS and D-SCOPE), in three Belgian municipalities (Ghent, Knokke-Heist and Thienen) were used and compared. The BAS data set (N = 1496) is a representative sample of community-dwelling older adults (60+), while the recruitment of the D-SCOPE sample (validation sample, N = 869) is based on risk factors (e.g. age, marital status, moved in the past 10 years). Frailty was measured with the comprehensive frailty assessment instrument (CFAI). The validity was examined by means of prevalence rates, distribution and the odds rates within both data sets.

The validation sample had an increase in the percentage of elderly who were mildly and highly frail for physical frailty (men: +17.0 percent point, women: +20.7 percent point), for psychological frailty (men: +13.4 percent point, women: +13.7 percent point), for social frailty (men: +24.8 percent point, women: +4.8 percent point) and environmental frailty (men: +24.2 percent point, women: +6.8 percent point). The present results indicate that the risk of being mildly or highly frail was higher in the validation sample in comparison with the BAS data.

The present study proved the validity of aforementioned risk factors. Selecting older people based on these risk factors proved to be an effective strategy for detecting frail older people.

Efficacious self-management at older ages requires the ability to make an accurate appraisal of one’s current and future health situation. Therefore, the purpose of this study is to explore how community living older adults, with different self-perceived health status, appraise their future health status and their future health-care and housing needs.

The study population, 555 community living older adults, aged 65–75, completed a questionnaire for self-screening of their general health status.

The results show that over 70% of the older adults, even many of those who perceive their own health status to be “poor” or “fair” and those who are “frail”, do not expect deterioration in their physical or mental health nor extra health-care or housing needs within the next half year. In addition, a substantial part of the respondents, particularly those who perceive their general health as less favourable, tend to have a “wait-and-see” attitude and want to live their life day-to-day.

Community living older adults may not always be able or motivated to monitor their own health condition and prepare themselves for changing needs. Supporting older adults by motivating and teaching them to monitor their condition and overcome barriers to engage in pro-active coping can help older adults to manage the negative consequences of ageing while they have still sufficient resources available.

The findings of this study can help health-care professionals to tailor the support of older adults’ self-management.

This paper aims to explore the match between needs and services related to participation for frail older adults receiving home care.

A qualitative multiple case study was conducted with 11 triads each involving an elder, a caregiver and a healthcare provider working in a Health and Social Services Centers (HSSCs).

Although HSSCs in Québec are supposed to promote social integration and participation of older adults, services provided to the older adults in this study focused mainly on safety and independence in personal care, dressing, mobility and nutrition, without fully meeting older adults’ needs in these areas. Discrepancies between needs and services may be attributable to the assessment not covering all the dimensions of social participation or accurately identifying older adults’ complex needs; older adults’ and their caregivers’ difficulties identifying their needs and accepting their limitations and the assistance offered; healthcare providers’ limited knowledge and time to comprehensively assess needs and provide services; guidelines restricting the types and quantity of services to be supplied; and limited knowledge of older adults, caregivers and healthcare providers about services and resources available in the community.

To improve and maintain older adults’ participation, a more thorough assessment of their participation, especially in social activities, is required, as is greater support for older adults and their families in using available community resources. It is also important to review the services provided by HSSCs and to optimize partnerships with community organizations.

The purpose of this paper is to examine the current policy of extending personal budgets to older people.

In developing this explanation, the paper draws upon a species of de-centred, post-foundationalist theory which draws attention to the way in which certain narratives can sustain a longing for the implementation of policies that are ultimately unachievable. The paper also draws upon original data from an evaluation of a national ageing charity’s project to increase take-up of personal budgets.

The paper draws attention to, and seeks to explain, the paradoxical discursive positioning of older adults as “the unexceptional exception” within the general narrative of universal personalisation.

This analytical approach can secure a different vantage point in this debate by paying closer attention to the ideological and ethical dimensions of personalisation than has been the case until now.

The paper contributes to the critical interrogation of the personalisation agenda, in which debate (both in academic and practitioner circles) has become highly polarised.

The paper contributes to discussions in critical social gerontology which point to a bifurcation of later life into, on the one hand, an ageless third age and a frailed fourth age, on the other.

The paper makes clear that the discursive positioning of older people as “the unexceptional exception” risks an inadvertent ageism.

Psychological frailty adds most to overall feelings of frailty, but is often neglected, although meaning in life is important for psychological well-being. The purpose of this paper is to explore the sources of meaning in life within psychologically frail older people.

Data (n= 16,872) generated from the Belgian Ageing Studies were collected, using the Comprehensive Frailty Assessment Instrument and the Sources of Meaning Profile (SOMP-R) instrument. Psychometric properties of the SOMP-R were explored using factor and reliability analysis and one-way-ANOVA analysis were used to asses mean differences.

Financial security, meeting basic needs and personal relations play an important role as sources of meaning in life. Moreover, the SOMP-R showed excellent psychometric properties.

Due to the cross-sectional design of this study, evolution in time and causal links could not be assessed.

The findings of this study emphasize that sources of meaning in life are relevant and can be assessed using the SOMP-R upon which individually tailored care plans can be developed. The results show that, meaning in life as such plays an important role for psychologically frail older people. As a consequence, this offers insights to support these older people. Caregivers and policymakers might therefore take these results into account. Guarantee and/or follow up a frail individual’s financial security, assessing and enabling one’s personal relationships and meeting their basic needs are very important when taking care of psychologically frail older individuals.

Besides the practical implications, the social inclusion of psychologically frail older people seems to be relevant.

To the best of the authors’ knowledge, the association between meaning in life and psychological frailty in later life is not yet investigated. Further the findings of this study emphasize that sources of meaning in life are relevant and can be assessed using the SOMP-R upon which individually tailored care plans can be developed.

This paper aims to explore residents' perceptions of a refurbishment programme to sheltered housing schemes and its impact on their well-being.

The methodology draws upon a realist evaluation framework. Four participatory appraisals (PAs) and 19 interviews with residents were conducted in the sheltered housing schemes. Ages of participants ranged from 50 to 99 years.

Two categories of residents were identified: healthy active older adults and older frail adults (or over 85+). Residents said their social and emotional well-being improved from the provision of indoor and outdoor communal areas. Older frail residents only accessed the new communal spaces when staff took them in their wheelchairs. The physical changes increased opportunities for social connections for residents. Conservatories and sensory gardens were most popular. Residents felt that structured activities in the new spaces and digital training would improve their social activities.

The participatory methods spanned over an hour, and some residents felt too tired to complete the full session.

A practical limitation was that some sensory rooms were not fully completed at the time of the evaluation.

This paper adds the following: Perceptions of residents of a refurbishment programme in sheltered housing and the impact on their well-being. Perceptions of residents about social activities after a refurbishment programme. Perceptions of residents about the impact of physical changes to their sheltered housing schemes and impact on their internal accessibility to the improvements.

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.

Self-determination is governed by ethical and legal rights in western society. In spite of that, older people are still restricted by others in their decision-making processes. The purpose of this paper is to explore older persons’ different conceptions of self-determination.

A qualitative phenomenographic interview study on frail older persons (n=15).

Three categories emerged, showing the variations of conception of self-determination as experienced by frail older people: first, self-determination changes throughout life; second, self-determination is being an agent in one's own life; and third, self-determination is conditional. In summary, while self-determination is changeable throughout life, and older persons want to be their own agents, and struggle to be that, certain conditions must be met to make it possible for them to be able to exercise self-determination.

Suggestions for supporting and strengthening frail older persons’ self-determination, and indirectly their well-being and health: to have a person-centered approach, treat them with dignity and respect and give them opportunities to influence and to feel involved; to improve their health literacy by, for example, supporting them with enough knowledge to be able to exercise self-determination; to make them feel safe and secure in relationships, such as with family and caregivers.

This study explores frail older persons’ own conceptions of self-determination to be able to gain knowledge of how professionals can support them so that they may experience self-determination in life.