Exploring Community-Based Care and Support Networks for Frail People

Many of us will need support as we age but who exactly provides that care? Dr David Sunkersing offers new insights into the support networks of frail people.

Frailty is a clinical syndrome, most common in older adults and associated with an increased risk of adverse health outcomes including falls, hospitalisation and reduced survival time. Many frail individuals therefore rely on family, friends, groups, healthcare professionals, carers and others to assist with their care and support needs and maintain both their independence and quality of life (a care and support network).

We proposed that understanding a frail individual’s care and support network from their perspective as well as the healthcare professionals involved, could improve patient experience and open opportunities for collaborative support. This could be through better understanding of the services, local authorities or people identified in the care and support networks, to help with planning and transfers of care (e.g. from a hospital setting into a community setting). Further, given reports of difficulty in verbally describing an individual’s social network, we used principles of social network analysis (SNA) to visually encapsulate the care and support networks.


We interviewed 16 patients and 16 associated healthcare professionals from a community-based NHS ‘Falls Group’ programme within North-West London. Individual (i.e., one on one) semi-structured interviews were conducted to establish an individual’s perceived network. We then used principles of SNA to help identify the structural characteristics of the networks; thematic analysis aided data interpretation.


Our study emphasised the importance of family, friends and healthcare professionals to an individual’s care and support network. We also highlighted the significance of informal carers and friends along with healthcare professionals in the care of individuals living with frailty. When we compared the networks, we found similarity in the makeup of ‘patient’ and ‘provider’ reported networks, but this was particularly evident of helper/carers in patients’ reports. These findings also highlight the multidisciplinary makeup of a care and support network, which could benefit healthcare professionals to support frail individuals.

The Future

We believe that our study paves the way for future research in this field. For example, given the contribution and importance of family/friends reported, an additional study could be conducted to understand the efforts made to contact, integrate and involve these groups of people (e.g., via NHS services) and to understand whether the contribution and importance of these groups remain consistent over time. We would also welcome research to investigate the reasoning behind the low number of carers/helpers reported in the care and support networks in this study.

David Sunkersing conducted his PhD in the Faculty of Medicine at Imperial College London, based at Chelsea and Westminster hospital.


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