Frail or not? An explorative mixed methods evaluation of a sensory-based frailty assessment toolkit

Abstract

The worlds population is aging (United Nations, 2015). As the aging population is more prone to developing frailty, it is important to assess and monitor this condition. Frailty is a state of health where ones overall well-being and ability to function independently are reduced, with an increased vulnerability to deterioration (Morley et al., 2003). Current assessment methods of frailty are prone to error due to human bias and memory loss and rely on well-trained clinicians to interpret results. Frailty is a dynamic condition and continuous assessment would assist in diagnosing the condition early on. A prototype of a frailty toolkit is being developed by Chao Bian and his team at the IATSL in Toronto to monitor and assess frailty in older adults’ homes. This toolkit will assess frailty by measuring Fried’s Frailty Phenotypes (Fried et al., 2001) through home monitoring technologies. It is important to involve older adults in the development of this toolkit as research shows that lack of user involvement is a reason for assistive technology abandonment. This study therefore researched older adults attitudes and preferences towards home monitoring technologies. A focus group study was carried out, which provided insights on what technologies older adults want to interact with and what issues were perceived with in-home frailty monitoring. Privacy proved to be a concern for most older adults, corresponding with previous research (Courtney et al., 2008). The data from the focus group was used to select technologies for the toolkit. This toolkit was evaluated with an online usability assessment. Results show that the toolkit in general was well received. However, participants indicated points of improvement such as the ability to personalize when users are prompted to interact with the toolkit. The results also suggested that proper explanation is needed to address why the toolkit is necessary for older adults and their clinicians.