The influence of psychological and social factors on the lived experience of ageing with co-existent frailty and cognitive impairment
Ellwood, Alison C.
Ellwood, Alison C.
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End of Embargo
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The University of Bradford theses are licenced under a Creative Commons Licence.
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Accepted for publication
Institution
University of Bradford
Department
Centre for Applied Dementia Studies. Faculty of Health Studies
Awarded
2023
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Abstract
Global policy has recognised the need to promote healthy ageing. Risk of frailty with co-existent cognitive impairment increases with age and is associated with adverse outcomes, which services may struggle to support. Understanding life experiences which could contribute to, or promote the self-management of, co-existent frailty and cognitive impairment would enable identification of those at risk and target services appropriately. This thesis aimed to understand how past and present, psychological, and social factors, may influence the experience of ageing with co-existent frailty and cognitive impairment and explore how services support those living with this co-existent decline.
This thesis involved two research studies. Older people living with co-existent frailty and cognitive impairment took part in participant-led life-history interviews. Health and social care professionals were also interviewed. Reflexive thematic analysis was used to analyse and explore patterns in the data.
Findings indicate that a range of psychological and social factors, throughout life, may contribute to decline. Physical decline was associated with ageing and accepted, whilst cognitive impairment was feared. Wealth, social networks, and lifelong psychological resilience were seen to promote coping and the management of age associated decline. Future dependency was a source of apprehension. The relative importance of factors is complex, as the impact of experiences and circumstances accumulate and interact.
A need to implement preventative measures across the life-course is implied. Professionals require training to understand how best to approach individualised care for those living with co-existent frailty and cognitive impairment, to promote independence and support dependency in old age.
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Type
Thesis
Qualification name
PhD