Understanding the needs and experiences of frail older people towards the end of life. Frail older adults are rarely offered palliative care. It remains unclear as to what model of palliative care is appropriate for them. The physical trajectory of frail older people is of a gradual dwindling decline yet how social, psychological and existential needs change over time and relate to physical changes is not understood. This study found patterns of physical, social, psychological and spiritual experiences that differ from the archetypal trajectories of other groups. In the face of threats to the sense of self, the frail older people valued alternative identities and struggled with the absence of clear causative factors to explain their circumstances. It may be helpful to encourage a focus of advance planning on addressing the fears of burdening others, of moving to a nursing home or of developing dementia. Such fears were more prevalent than fears of dying. Community health and social care structures and networks appear essential for supporting the end of life needs of frail older people. Understanding the distinct losses and sustaining factors that contribute to the wellbeing of frail older people is integral for assessing how best to offer care and support. A direct application of the cancer care model may not be helpful. Funder ESRC PhD Studentship awarded 2015 Researcher Dr Anna Lloyd PhD Supervisors Scott Murray, Marilyn Kendall, John Starr This article was published on 2024-09-24
