The role of self-directed learning in older adults' health care

This descriptive study expands the understanding of the impact of self-directed learning (SDL) on older adults’ health care. Findings reveal motivating and controlling factors that influence learners, identifies a SDL process specific to health care, offers insights into the perceptions older adults’ hold, and barriers they encounter. Introduction The U.S. population is comprised of 35 million adults aged 65 and older. By 2030, the number of older adults will have doubled to 70 million, or one in every five Americans (National Center for Chronic Disease Prevention & Health Promotion, 2002). Commonly, older adults are the most frequent users of medical services and their growing numbers are placing increasing demands on medical and social services in the U.S. In the United States, almost one-third of today’s health care costs, $300 billion each year, is for older adults. Chronic diseases exact a heavy health and economic burden on nearly 40% of the older adult population living within the community due to associated long-term illness, diminished quality of life, and greatly increased health care costs (National Center for Chronic Disease Prevention & Health Promotion, 2002). In addition, older adults’ health is often compounded by multiple health conditions and adjustments to later life events such as deaths of spouses, partners, friends, and loved one, loss of homes, financial challenges of retirement years, and societal changes (Deluca & Enmar, 2001; Neugarten, 1996; Roberson, 2003). In response to the increasing numbers, costs, and health care needs of older adults, the medical establishment has changed patient-care policies. For example, managed care provider reimbursement polices have created incentives to move patients quickly through the health care system and have pressured physicians to limit office visit time for dialogue and health education. In response to these changes, health educators have been promoting an active role for the patient in their own health care (Berman & Iris, 1998; Keller & Fleury, 2000; National Centers for Chronic Disease Prevention & Health Prevention, 2002. The importance of understanding factors contributing to health maintenance is especially relevant for older adults, as it is this segment of the population who typically face the greatest health risk. Older adults who have taken control of their health care are self-directing their own learning. However, little is known about how older adults are using self-directed learning to gain access to health information and how this information is affecting their health care. The purpose of this study was to further the understanding of the role of SDL in older adults’ health care. The research questions that guide this study are as follows: 1. What motivates older adults to take control of their learning regarding health care? 2. What health care behaviors are controlled by self-directed learners? 3. What contextual factors are controlled by self-directed learners? 4. What is the process of SDL of one’s health care? 5. How does SDL affect one’s health care? 6. What barriers do learners experience in the self-direction of their health care?