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Exploring Frailty in Indian and Fiji Indian Older Adults in a New Zealand Setting

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Thesis embargoed until 5th June 2027(7.84 MB)

Date

2024

Authors

Supervisor

Zambas, Shelaine
Macdiarmid, Rachel

Item type

Thesis

Degree name

Doctor of Health Science

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Publisher

Auckland University of Technology

Abstract

Background: Frailty is a multidimensional and dynamic disorder in which vulnerability is increased due to ageing-associated decline in reserve and function. Frailty can lead to falls, comorbidities, decreased quality of life, impairment, dependency, loneliness, hospitalisation, admission into aged residential care (ARC) facilities, as well as mortality. Chronic health conditions are associated with frailty. Chronic health conditions are prevalent in Fiji Indians and Indians who live in New Zealand; thus, frailty is also likely to be prevalent. Despite such negative effects of frailty in older age, little attention has been paid to understanding frailty in Indian and Fiji Indian older people in New Zealand. Family relationships, social interaction and culture hold immense value for this population group. Therefore, this study seeks to explore the meaning of frailty in Indian and Fiji Indian older adults living in New Zealand. Aim: This research aims to explore and understand what frailty means to community-dwelling Indian and Fiji Indian older adults living in Aotearoa New Zealand. Methods: An interpretative descriptive study was conducted in two phases. Phase 1 consisted of three focus group interviews in Fiji Hindi, English, and Hindi. Phase 2 involved 12 individual interviews in the language of the participant’s choice of Fiji Hindi, Hindi and English. Once the interviews were transcribed and translated, thematic analysis was used to develop key themes. Results: The findings revealed an overall notion of loss that participants attached to frailty, which entailed loss of independence, connectedness and meaning. The loss of independence was linked to feeling like a burden or feeling they were carrying a burden; loss of connectedness was due to loneliness and social isolation; and loss of meaning was due to participants feeling they were alive but not living their lives as they wished, or due to the loss of their loved ones. Discussion: The Indian and Fiji Indian older adults in this study have portrayed some specific needs in relation to frailty. The study has revealed the various meanings of frailty in this vulnerable group of people that include both men and women. Although there are multiple issues pertaining to frailty in this population group, women were most affected by frailty. This was due to their own perceptions and expectations, as well as the demands and expectations of their family and society. Many of the participants were also affected by bereavement. Conclusion: This study has uncovered the struggles that the community-dwelling Indian and Fiji Indian older adults are facing in New Zealand. It has provided some insight into ways to improve policies, procedures and practices for health professionals working with Indian and Fiji Indian older adults to identify frailty and support members of this group who are experiencing frailty. We cannot unsee what we have uncovered and thus the onus is on health professionals to address these specific concerns professionally and ethically as it is our duty of care to address frailty in all population groups, including Indian and Fiji Indian older adults living in New Zealand.

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http://hdl.handle.net/10292/19265

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Doctoral Theses