Frailty and dementia: promoting health assets and resilience

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This article has been double-blind peer reviewedIn this article…• Drawbacks of the biomedical model in our approach to frailty and dementia• Concepts of deficit-driven and asset-based approaches• Role of health assets and resilience in improving quality of lifeAuthorsShibley Rahman is a freelance researcher and academic physician in frailty and dementia; Karen Harrison Dening is head of research and publications at Dementia UK; Tom Dening is professor of dementia research at the University of Nottingham.Characterising people simply through the problems arising from illness or the health deficits it causes, does not adequately take into account personhood or the complexity of multimorbidity. Frailty and dementia are two long-term conditions that need to be viewed in a more holistic way than solely through a biomedical lens. Rather than just measure and count health deficits to come to a diagnosis and treatment plan, it would be useful to recognise that health assets and resilience can improve the quality of life of people living with frailty and/or dementia and their families. This article discusses these issues and proposes that a ‘resilience measure’ is needed to complement the cumulative deficit model.CitationRahman S et al (2018) Frailty and dementia: promoting health assets and resilience. Nursing Times; 114: 9, 50-54.Talking pointsLiving with frailty or dementia is not necessarily synonymous with living with health deficitsIn frailty, considering health assets and resilience is essential to help patients and carers avoid following a downward spiralThe perception of frailty and dementia needs to include positive wellbeing and acknowledge the primacy of personhoodEmbracing people's assets and resilience is vital for selfmanagement and behavioural changeAddressing the personal priorities of people living with long-term conditions could be more useful than fixating on interventions

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