Activation among chronically ill older adults with complex medical needs: challenges to supporting effective self-management

J Ambul Care Manage. 2011 Jul-Sep;34(3):292-303. doi: 10.1097/JAC.0b013e31821c63b1.


Successful chronic care ideally involves patient engagement, but little is known about chronically ill older adults' ability to self-manage their health. This study examines activation among hypertensive patients older than 65 years. Almost 60% of participants scored in the bottom half of the activation scale; only 8% scored at the highest level. Higher activation was associated with higher self-ratings of health, health literacy, and receipt of patient-centered care, shorter lengths of stay, and lower depression and hearing impairment levels. Effective self-management support for chronically ill elders will likely require varied strategies and may need to address depression, health literacy, and/or hearing impairments.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Female
  • Geriatric Assessment
  • Health Knowledge, Attitudes, Practice
  • Health Literacy
  • Health Services Needs and Demand
  • Humans
  • Hypertension / therapy*
  • Male
  • New York
  • Patient Participation*
  • Patient-Centered Care
  • Self Care*
  • Surveys and Questionnaires