Remaining healthy is a top concern for many older adults. Of particular concern is staying mentally sharp and physically fit. People can stay healthy as they age, in part, by assuming personal responsibility for their health by taking preventive measures to guard against illness and disease. While access to preventive services and quality health care are important components of health promotion, they are not enough. Social determinants of health—such as access to employment, education, housing, healthy foods, safe streets and neighborhoods, and social supports—are important predictors of health outcomes and health behaviors. Interventions and public policies at all levels of government can reduce barriers to healthy living and influence health outside of formal medical care systems. Evidence-based exercise programs have shown improvement in individuals’ health and well-being.
To maximize health outcomes, consumers and their family caregivers must understand how to engage effectively with medical systems. This includes community-based resources that support and promote health. Formal health systems are shifting more decisions and costs to consumers and their family caregivers. It is important that they are equipped with the knowledge and skills to successfully work with these systems to maintain or improve health.
Definitions of consumer and family engagement vary. In this chapter, they refer to providing consumers and their family caregivers with the knowledge, skills, and other tools they need to play an active role in maintaining and improving health and well-being. It also means helping consumers and family caregivers overcome structural and personal barriers to engaging with formal and informal systems of care.
Maintaining cognitive health is a key component of healthy aging. Emerging evidence suggests that lifestyles that include physical exercise, good nutrition, social interaction, stress reduction, healthy sleep habits, and mental engagement can improve cognition. It can also potentially reduce the risk of cognitive impairment and related forms of dementia. As the U.S. population ages, the costs of providing care and services to individuals with cognitive decline, related dementia, or both are likely to increase. This has a significant impact on health and quality of life for individuals and their families. And it strains health resources. Individuals need assistance from health care, government, and private entities to maintain and improve cognitive health throughout their lifespans.
Finally, a growing number of consumers now have access to their health information through electronic health records. There is also increasing amounts of information on all aspects of health care available through online sources. This information may help consumers and family caregivers make better health care decisions. However, decisions concerning insurance coverage, provider networks, and treatment options have become more complex. They now demand higher-level understanding and engagement from consumers and family caregivers. Some consumers face challenges that prevent them from actively advocating for themselves. Consumers with low health literacy, cognitive impairment, and those who are ill, in pain, or experiencing stress from a health condition may not be in a position to engage actively in this process. In addition, accessing transparent information on price and quality performance remains challenging. Many health care decisions (e.g., whether to seek health care and where to go for care) can have substantial financial consequences for individuals and the health care system.
To promote and encourage greater engagement from consumers, transparent information on price, quality, and outcomes must be available in ways that are accessible to consumers and families. The infrastructure should be in place to help consumers and family caregivers understand how that information can help them make better choices. Some individuals need help to better engage with providers, health care systems, and health insurers. A high-quality health care system adapts to the individual needs of consumers and their families. Family caregivers or others who take on the role of advocating and caring for people unable to advocate for themselves require support systems. Consumers’ health goals, preferences, and outcomes should be elicited and become part of their health care plan and treatment options.