Health-care consumerism and access to health care: Educating elders to improve both preventive and end-of-life care

This chapter discusses challenges faced by older adult health-care consumers in obtaining access to responsive care from physicians relevant to a broad spectrum of health issues ranging from prevention to chronic illness and end-of-life care. Based on our prior research with communitydwelling elders (E. Kahana & B. Kahana, 2003, 2010), we propose a conceptual model of consumer self-advocacy for better access to effective health care in late life. We argue that older adults who are well informed and confident health-care partners and who involve their physicians in active dialogue will experience better care, and will be more satisfied with their health care. We present findings from our studies of cancer prevention and from our research focused on end-of-life care relevant to patient self-advocacy. We also discuss the role of educational interventions and of patient empowerment in facilitating greater access to responsive health communication and health care, particularly among elders who are disadvantaged and who have low health literacy.