PLAIN ENGLISH SUMMARY The paper discusses engaging older adults living with frailty and their family caregivers. Frailty is a state that puts an individual at a higher risk for poor health outcomes and death. Understanding whether a person is frail is important because treatment and health care choices for someone living with frailty may be different from someone who is not (i.e., who is fit). In this review, we discuss strategies and hurdles for engaging older adults living with frailty across three settings: research, health and social care, and policy. We developed this review using published literature, expert opinion, and stakeholder input (including citizens). Engaging frail older individuals will be challenging because of their vulnerable health state - but it can be done. Points of consideration specific to engaging this vulnerable population include:In any setting, family caregivers (defined to include family, friends, and other social support systems) play an important role in engaging and empowering older adults living with frailtyEngagement opportunities need to be flexible (e.g., location, time, type)Incentivizing engagement for researchers and citizens (financial and otherwise) may be necessaryThe education and training of citizens, health and social care providers, and researchers on engagement practicesPatient-centered care approaches should consider the specific needs of individuals living with frailty including end-of-life care and advanced care planningInfluencing policy can occur in many ways including participating at institutional, regional, provincial or national committees that relate to health and social care. ABSTRACT Older adults are the fastest growing segment of Canada's population resulting in an increased number of individuals living with frailty. Although aging and frailty are not synonymous the proportion of those who are frail increases with age. Frailty is not defined by a single condition, but rather a health state characterized by an increased risk of physical, mental, or social decline, deterioration of health status, and death. Recognizing frailty is important because earlier detection allows for program implementation focused on prevention and management to reduce future hospitalization, improve outcomes, and enhance vitality and quality of life. Even though older adults living with frailty are significant users of health care resources, their input is under-represented in research, health care decision making, and health policy formulation. As such, engaging older adults living with frailty and their family caregivers is not only an ethical imperative, but their input is particularly important as health and social care systems evolve from single-illness focused to those that account for the complex and chronic needs that accompany frailty. In this review, we summarize existing literature on engaging older adults living with frailty and their family caregivers across three settings: research, health and social care, and policy. We discuss strategies and barriers to engagement, and ethical and cultural factors and implications. Although this review is mainly focused on Canada it is likely to be broadly applicable to many of the health systems in the developed world where aging and frailty pose important challenges.

中文翻译：

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向身体虚弱的老年人及其家庭照料者发出声音：让身体虚弱的老年人参与研究，医疗保健决策和健康政策。

普通英语摘要本文讨论了活弱体弱的老年人及其家庭照顾者的参与。身体虚弱是一种使个人健康状况不佳和死亡的风险更高的状态。了解一个人是否身体虚弱很重要，因为对于身体虚弱的人而言，治疗和保健选择可能与身体虚弱的人（即健康人）不同。在这篇评论中，我们讨论了在以下三个方面吸引脆弱的老年人的策略和障碍：研究，健康和社会护理以及政策。我们使用已发表的文献，专家的意见和利益相关者（包括公民）的意见来开发此评论。由于脆弱的健康状况，让衰弱的老年人参与进来将具有挑战性，但可以做到。与健康和社会护理有关的省或国家委员会。摘要老年人是加拿大人口中增长最快的部分，导致越来越多的身体虚弱的人。尽管衰老和衰弱不是同义词，但衰弱者的比例却随着年龄的增长而增加。体弱不是由一个单一的条件定义的，而是一种以身体，精神或社会能力下降，健康状况恶化和死亡风险增加为特征的健康状态。认识到脆弱是很重要的，因为及早发现可以使计划的实施重点放在预防和管理上，以减少未来的住院治疗，改善结局并提高活力和生活质量。即使年老体弱的成年人大量使用卫生保健资源，在研究，卫生保健决策和卫生政策制定中，他们的投入不足。因此，让年老体弱的老年人及其家庭照料者参与不仅是道德上的当务之急，而且由于卫生和社会照护系统已从单一疾病发展为解决伴随着复杂而长期的需求的疾病，他们的投入尤其重要虚弱。在这篇综述中，我们总结了现有文献，涉及在三个方面：研究，健康和社会护理以及政策，来吸引体弱的老年人及其家庭照料者。我们讨论了参与的策略和障碍，以及道德和文化因素及其影响。