Table 5 Quotations to illustrate coping strategies and unmet needs

Individual level—coping strategies

 Avoidance

  • I’ve stopped going to [the supermarket] because I struggled to get round. I have to push the trolley six feet in front of me and then catch it up. I used to be able to walk with one crutch and one hand on the trolley and get round quite easily. I can’t do that now, so you have to push the trolley and then catch it up and then put your stuff in and then push the trolley and catch it up. And you hear people saying oh look at that poor bloke over there, look at that poor old fella. Old ladies coming up and saying can I help you and things, and I should be saying that to them.’ (Participant 16, male, vulnerable, age 60s).

 Vigilance

  • ‘Since the previous [fall] I try and have my mobile on me, and I decided to get one of these the alarm things.’ (Participant 12, male, mildly frail, age 70s).

  • ‘You think of what you are doing because if you are concentrating on what you are doing you are not going to do something like slip.’ (Participant 25, male, moderately frail, age 70s).

 Adaptation

  • ‘I find different ways to do things… it might not be conventional, but I find ways.’ (Participant 23, female, moderately frail, age 60s).

  • ‘We’ve got lifts to get us in and out of the bath, lifts on the bed, grab rails everywhere, raised toilet seats with arms, a reclining chair. All sorts of things. Cars that have got adaptations with hoists to lift scooters.’ (Participant 13, male, vulnerable, age 50s).

 Resignation and acceptance

  • ‘You have to get used to it when you are in this position you know. I don't like it, but you have got no choice.’ (Participant 15, female, moderately frail, age 80s).

  • ‘I have given up; I have given up hope.’ (Participant 2, male, moderately frail, age 70s).

Interpersonal level—others responses to frailty

 Over protection

  • ‘My daughter warned me not to go upstairs. I went up once …I had got a rail each side, so I went up with the rail and I just sort of peeped my head around the bedroom doors without getting off the stairs. I daren’t stand up on the top step and walk. When I told them, they went mad they said I hadn't got to go up again. They thought I would fall down. So, I had strict instructions I hadn't got to up the stairs.’ (Participant 14, female, moderately frail, age 80s).

 Burden

  •‘You don't tend to pass the problem onto somebody else simply because you don't want to burden other people…because it means then that now they have got a problem they didn't need, they didn't want.’ (Participant 25, male, moderately frail, age 70s).

Interpersonal level—unmet needs

 Listening, empathy and rapport

  • “We have enough to go through without people treating us like we are nothing… You have got to be able to put yourself in somebody else’s shoes. I am like I have got loads of problems and you don't, so you don't know.” (Participant 3, female, vulnerable, age 40s).

  • ‘We have that kind of relationship between me and my GP. He’s very good at listening and deciding. Sometimes he’ll suggest things that I wouldn’t have thought of.’ (Participant 16, male, vulnerable, age 50s).

  • ‘The nurses, the medical staff here are very good…we see them three times a week, so we know them on the first names we know who has got a child and what the child’s name is. Do you see what I mean, we know their home life. Rapport is important…. it came down from [the top] that we should be made to feel valued.’ (Participant 10, female, vulnerable, age 50s).

 Unresponsive care

  • ‘The doctor decides what will happen if there is a problem and every three months I have a clinic and they get the report on the computer and they decide what tablet I am going to take.’ (Participant 18, female, vulnerable, age 60s).

  • ‘When I told them I had a fall they didn't want to know. They said…you are perfect, your levels are perfect.’ (Participant 6, male, vulnerable, age 50s).

 Deferential relationships

  • ‘I just go by what they say when they tell me.’ (Participant 23, female, moderately frail, age 60s).

  • ‘If they [the doctor] felt it probably was helpful for me then they would have done it a long time ago.’ (Participant 11, male, severely frail, age 60s).