Unravelling the differences between complexity and frailty in old age: findings from a constructivist grounded theory study.

UK health policy has used the terms 'frailty' and 'complexity' synonymously but there is no common definition for either. Understanding these concepts is important if demand for health care created by the increasing number of older people in society is to be managed effectively. This paper explores some findings from a study into how mental health nurses who work with older people construct and operationalize the concept of 'age-related complexity'. Constructivist grounded theory was used. Audio-taped interviews were undertaken with 13 registered nurses and were analysed using a constant comparative method. This paper addresses the relationship between frailty and complexity, which was identified as a theme within the category 'dynamic complexity'. The findings suggest that nurses understand important differences between the two concepts. Frailty is exclusively used to describe physical states while complexity is a more encompassing term that has resonance and relevance in mental health services. The dynamic nature of complexity means that older people can become both more and less complex and this has implications for nursing practice that require further study.