Observations and reflections based on the experience of elderly caregiving

Studies dedicated to the process of frailty in geriatrics and gerontology, and also the attempts to individualize a new geriatric syndrome it was a concern in the last years. The authors of this paper, having an unique experience in caring for frail elderly (one of us directly cared frail elderly patients for more than thirty years) have accumulated many observation – clinical, laboratory, nursing and prevention – opportunity for reflection based on author’s opinions. The most important reflection expresses primarily the difficulty to mark off such a syndrome, to have a consensus, which is a condition to integrate a new entity. The rich semiology of elderly patients, the (multi) functional decline inspired over the years many researchers who elaborated nosological descriptions overlapped, more or less to the frailty syndrome. UNO proposed from several years a classification of elderly in the “active elderly” and “frail elderly”. Others described the psycho-motor regression has described as “elder’s multiple vulnerabilities syndrome”. Moreover, frailty is not a specific status of the elderly, but it could be interpreted rather as a “state” than a syndrome, such as bedridden condition, terminal condition, state of dependence, severe stages of dementias and so on. Despite the difficulties of defining the concept of frailty brings some benefit concerning the understanding of the specificity of elderly patient, the holistic approach of his problems, not least provides tools to indicate the need of preventive measures, with good effects on the longevity and the quality of life.