Table 2 Representative quotations for each factor (after [32])

Value

Suppose there was a paper copy of what was on the website as well, because there is this assumption that everybody wants to go to a computer. Sorry, there are still groups of us who don’t necessarily automatically do that…..So I think your consensus round here is that it might be a very good idea [screening] but don’t just think technical. [UK Robust Older Adult 13]

The way I was thinking about it just then was to see it as being most useful in primary care but would be something that would be part of their records which would be accessible if they were to go in to hospital, you’d have more of an idea. If that information were available, not just a score but […] a quick snapshot of what the vulnerabilities were, that would be incredibly useful information […]. I can’t see, the idea of doing it online, yeah that would be great for those who aren’t actually frail but I think for those who are, then you are actually going to be missing out on a lot of the people with greatest need because they’ll have visual problems or they’ll have anxieties about computers and stuff like that. I don’t see that as being terribly helpful. [UK Health care professional 30]

I think you’d be able to target services if you were all singing from the same hymn sheet because we have difficulties at times identifying urgency and priority and being able to respond but if you were told, this person’s got a frailty score of 4 and that was quite high, right okay, we’ll get out, we’ll do that intervention [UK Health care Professional 21]

We need computer systems that talk to people, that highlight … and if we were able to get more savvy…., it would reduce duplication for some services, get in at the right time, get that quick intervention to get them back on the even keel [UK Health care Professional 21]

Perhaps training for some caregivers, but also a website, because not only do they work and can’t make it sometimes, but they also have little time for their family as they are preoccupied by that elderly person. How are they supposed to go for training? It’s a problem. Nothing against training for the elderly. [Poland Healthcare Professional 7]

Affordability, Accessibility and Usability

We’d be lucky if they have a computer. [UK Health care Professional 20]

From an Internet point of view, most of our patients don’t have access to the Internet at home. [UK Health care Professional 18]

I do not have a computer. [Italy Robust older adult 1]

Yes, I can use a computer but I don’t own one, I go in the library. I mean no library now is open at nine o’clock. If it was, I’d probably pop in and see if I could do it but there again, they’re on a timer and after half an hour they go off, they’re on a timer. You might get two hours, I’d have to mention it. No, the libraries don’t open until nine, ten at night [UK Frail Older Adult 2]

Everybody’s got a television. All the old people have got televisions. If you had a keep-fit on television, I think that might be a good, […] but it’s a good thing to have, exercise, it’s a good hour of exercising, in a chair mostly and because it’s a physio doing it, it’s not doing you any harm. [UK Frail Older Adult 3]

Internet no.. we need to wait a few years. Nobody uses it [Italy Family Caregiver 5]

I have got a mobile, I take it with me, but I cannot use it. [Italy Robust older adult 11]

We didn’t have a mobile phone, somebody had made an assumption that everybody has a mobile phone [UK Frail Older Adult 12]

Social support

No. so that couldn’t be something that would be easily accessible and often a lot of our patients do have a cognitive problem so they wouldn’t remember to practice the exercises on their own. They would need to rely on carers or family to practice them with them, in order to notice any difference. [UK Health care professional 18]

I don’t know because I put the exercise DVD on and I never do it. [UK Social care professional 6]

You know my Father had Parkinson’s and he had exercises that were shown to him by a physiotherapist and whilst he was seeing the physiotherapist he maintained them but it was quite difficult because after they stopped, Mum did her best, she tried to do the ‘elephant arms’ and things every day but it’s much harder to maintain that when you need to do it on your own. [UK Health care professional 30]

After retiring I went to computer classes. My husband did not feel like it, but I felt like going. I have got six grandchildren, and they help me. [Italy Robust older adult 4]

Emotion

These days, the Internet’s good for lots of things but it is bad for this, because it isolates people. [UK Family Caregiver P15]

There are many people who use the computer and just get isolated. [Italy Robust older adult 11]

P12: ….You know, you’re thinking about the computer, there’s a lovely example in this place, we were in car park 12 and as usual the parking meters, the pre-payment meters weren’t working and there was a new notice up telling you to get on your mobile phone and pay that way. Now a) we didn’t have a mobile phone, somebody had made an assumption that everybody has a mobile phone and b) even if we had got a mobile phone we wouldn’t make a financial transaction using a mobile phone. You know there’s a lot of assumptions made in different places about different things by….[UK frail older adult 12]

I hate it, even when it is simplified [Italy Robust older adult 9]

Experience and Confidence

In addition, I think that such a website is a nice thing. For example, I have some rather old patients suffering from insomnia, and they say: “Doctor, if not for the Internet, I’d have long gone crazy. When I wake up, I can always browse or read something.” [Poland Healthcare Professional 7]

I mean I find forums quite useful things [UK Robust older adult 1]

Television makes me sleep and the computer I cannot use it [Italy Frail older adult 9]

No, we’re too old for that [using a computer]! [UK Frail older adult 26]

I struggle to use one [a computer] [UK Frail older adult P10]

It depends on their state of mind doesn’t it? Some people, yes, they’d probably be quite happy to do it, others would probably be like, well I’m eighty odd, I’ve lived my life, whatever’s going to happen, is going to happen. I’m just going to do what I want. [UK Health care Professional 7]

Books and the Internet are my escape. I am glad that I still have good memory. My wife says that I have a computer in my head. You know, my mind is still functioning properly [Poland Robust older adult 7].

I can manage. I do not feel cut out. For instance, today the nurse has sent my test results with some indications. [Italy Robust older adult 4]

Independence

Well with carer support, I suppose like you said, if someone was sitting alone at home and they already felt like they didn’t want to go outside and they felt frail and vulnerable, giving them questions like “How many times do you go out a week?” and “Can you walk to the shops?” and they’re like “No, no” it might make them feel worse. [UK Health care professional 29]

That’s what I think we are worried about because then that could feed in to yeah, further concrete thinking around “Wow, if that’s what the score says, I must be” and then kind of living according to that. It might feel quite trapping. [UK Health care professional 28]