7 May 2022


Old Adults and Health Services

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First of all, it is essential to refer to the fact that the inherited genetic variations as well as great heterogeneity are included into the significant part of the relative resilience of some individuals in the aging process (Ferrucci et al, 2008). In the scope of this paper, the brief overview of the recent findings as well as the comparison analysis of the formal health care services, hospice services and assisted living housing in different cultures would be conducted.

It is obvious that the healthcare is an essential component of the proper living for all people. It may vary across the cultures as well as special aspects of the service are attributed to the different age groups and to addressing of the set of various disorders. While taking into account the fact that this aspect is urgent for the elderly population, as it is referred as the existential question, the healthcare services for this layer of population is one of the central aspects of the healthcare systems in all societies. Through history, people have invented different options for the health condition improvement. One of the central aspects of such inventions was to delay inevitable. Currently, the biomedicine evolves to the higher level as well as it is able to address different communicable diseases. At the same time, while referring to the statistical data, significant number of the world’s populations is aging and that is why, these people need different type of the health care intervention. This question has become urgent for different nations – as there is a common trend of underutilization of the hospice services and living housing.

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In this paper, the major reasons for such trend would be discussed and assessed, while referring to the practical examples from different cultures. The first determining factor is the numeracy skills and literacy. These skills are critically important in the complex health care systems of the developed countries. At the same time, the following question emerges – particular traits, skills and abilities which are critically important for the countries, where population represents the lower probability of gaining assistance form the Western medical system. In such case, the major emphasis should be put on the ways of the functioning of the health communications in the in non-Western culture as well as the practical importance of such knowledge for the patent’s adherence improvement and provision of the healthcare professionals with the accurate information regarding the patients’ actual understanding of their health condition.

As an evident example it is possible to refer to the fact Chinese healthcare culture is mainly oriented on improvement of the functional health literacy through teaching the population about the ways of avoiding the risky behaviors rather than on making attempts of explaining the scientific background of each particular disorder or disease or convincing the population that they should be responsible for their own health and control their environment.

In those countries and cultures, where it is possible to see the earlier stages of the demographic transition and where the rates of mortality and infections are extremely high, the major emphasis should be put on provision of such information to the population, which is able to improve the functional health literacy.

At the same time, in the developed countries (such as USA and UK), which may be characterized by the increased rates of the chronic conditions as well as the longer life expectations, both autonomy and adherence are useful. That is why, it is considered by the experts that in these countries, the core emphasis should be put on the set of the following aspects of effective healthcare - for living a longer and healthier life, the patients should be personally responsible for directing their care and managing the illnesses; the physicians should be able to treat significant number of the interrelated problems of old age.

One of the unique traits of the long-term care movement, oriented on the consumer, is its placement within the long-term care systems, which are publicly funded. In UK and US, as well as in the set of the European nations, the older population is provided with an access to the funding from the public programs – for hiring the workers, chosen by them (or even more. Preferring their family members). This, it is possible to state a fact that the essential step is represented by such movement in terms of “respecting the rights and expertise of older people needing services” (Kunkel et al, 2014. p.151). Even while it may seem natural that the older adults are able chose particular healthcare services they need, as well as express preferences regarding the way and time of offering these services, at the initial stages of the consumer-directed movement’ development, there were numerous concerns and controversies, regarding this issue. The central themes of disputes were the following: either the elderly people are able to manage their own care in an effective manner or not; either the consumer-employed workers would take advantage of them or not; the estimated rates of abuse and fraud in such case; the quality of the health outcomes etc.

It was indicated by the careful investigations that in such countries as US, UK and some EU countries, the self-directed care is an effective option for the elderly care: there are decreased rates of abuse and fraud; the health outcomes are improved (in comparison with the traditional care) and there is a higher rate of the patient’s satisfaction. Such trend may be attributed to the cultural traits of the above listed countries as well as by the properly-developed system of healthcare.

It is essential to note that at initial stages of its evolvement, the consumer-directed care was widely disputed in US society; this trend may be attributed to the fact that the medical model dominated in the country – the elderly population was expected to be passive and thus, it was estimated that they were not able to be actively engaged into the process of their own care. Additional reason for such trend is the “paternalism in publicly funded programs that invests rights and responsibilities with the care providers rather than the receivers” (Kunkel et al, 2014. p.151). In developed countries (such as UK, US, Western Europe) each of the above listed assumptions is challenged in a slow, but at the same time, successful manner by the disease self-management programs and consumer-directed care. At the same time, in the less developed nations (such as Russian Federation), where the access to the paid long-term care services, provided by the professionals, may not be readily available to the mass population, the responsibility of the patients as well as the self-care involvement are usually practiced. The last issue to be considered is Eastern culture and its impact on the attitude towards death and dying, which , in turn, has the potential of making a heavily impact on the understanding of the importance of the end-of-life care delivery.

To conclude it is essential to outline the major factors, which make their impact on utilization of the living housing and hospice services in different countries. First, it is economic development of the country and its population; secondly, it is a philosophical attitude towards diseases and their treatment; the last issue is religion - when death is not perceived as the tragic event, which should be prevented.


Ferrucci, M.L., Singleton, A., Guralnik, J.M., Murray, S.A., Bandinelli, A. Corsi, T. Frayling, S. (2008) Genetic variation and resilience in human aging. The Gerontologist 48(Special Issue III): 1-770.

Kunkel, S.R., Brown, J.S., Whittington, F.J. (2014) Global Aging: Comparative Perspectives on Aging and the Life Course. Springer Publishing Company

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StudyBounty. (2023, September 14). Old Adults and Health Services.


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