Health Literacy and Elderly Patients: A Case Study

This case study explores the impact of health literacy on elderly patients, with a focus on a specific case. It discusses the importance of health literacy, the challenges faced by elderly patients, and potential interventions to improve health outcomes.

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“Health literacy is the ability to access, understand, evaluate and communicate
information as a way to promote, maintain and improve health in a variety of settings across
the life-course.” (Rootman, 2008). Health literacy enables people with a disease to
understand the disease better and seek medical help at the right time. The aged may suffer
from loneliness, chronic disease and debilitating conditions. Being health literate can help
them seek treatment and improve health outcomes. But it has been observed that lack of
information about possible treatment often impacts their health outcomes negatively.
Subject of the case study, Fiona, an elderly person suffers from loneliness, lives
remotely, is socially isolated and has problems with vision and suffers from arthritis. She has
a problem understanding legal and medical terminology. And does not know how to approach
or find a physician whom she can trust. Loneliness among the elderly has an impact on their
mental and physical health. Diminished social contact can cause social distress (Richard, et
al., 2017). Due to generation gap there may be a sense of embarrassment when trying to
communicate making it difficult for the elderly to meet health literacy goals (Chesser, et al.,
2016). Individuals with low health literacy are less likely to take preventive steps and so are
more likely to suffer from chronic disease. It is difficult for them to navigate the healthcare
system and prevent illnesses because they may not have had the literacy to get an annual
influenza vaccine or undergo cancer screenings. Health literacy indicates good self
management skills, good utilisation of health services for emergencies and preventive
healthcare. Patients with health literacy are more likely to adhere to medication, knowledge
about disease, and thus there is reduced premature mortality (Bush, et al., n.d.). Health
literacy helps individuals to obtain information about health and use it for their own benefit
(McCaffery, et al., 2016). Educational intervention trials have been made with the goal of
improving health literacy among the elderly in Australia. The study tried to improve self
efficacy by imparting knowledge about complementary and alternative medicine and to see

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whether the lessons improved the uptake of alternative medicine among them (Smith, et al.,
2017). The intervention made use of the internet or a DVD and a booklet, while the control
group received only a booklet. Another study reviewed the effect of complex educational
interventions in the area of self management of patients suffering from osteoarthritis with the
aim of improving the management of the chronic condition and promoting reduction in pain
and discomfort. The self-management programs were meant to supplement the medical
treatment and improve patient outcomes. It was found that self management following the
educational interventions may alleviate pain in patients but not to a clinically significant level
(Kroon, et al., 2014). Many health inequalities are due to low health literacy. An educational
intervention that sought to remove health inequalities through an educational program was
found to be effective in raising the levels of health literacy among the participants (Muscat, et
al., 2016). The use of internet may reduce the social isolation of remotely located people to
some extent. It is also possible to reduce their sense of helplessness in accessing medical if
they remain in contact with friends, family or healthcare professionals through the online
mode.
In Fiona's case two health issues may need immediate attention. According to her ''her
eyes play up'', so she avoids driving. Her eyesight needs to be checked and she should be
advised a detailed eye exam. Also, her blood sugar levels should be examined to check if she
has diabetes. If left untreated it could lead to problems with visual acuity, macular
degeneration or retinal disorders. Eye problems have also been studied as precursors of
dementia among the elderly. Studies have found n association between eyesight problems and
the onset of Alzheimer's (Rogers, 2010). So it is important that vision problems be treated as
soon as possible. The correlation between eyesight problems and cognitive decline is
particularly alarming. Fiona also suffers from osteoarthritis and it has worsened in her knee
joint. Treatment for osteoarthritis is a high priority for her because she is pain all the time.

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There are several risk factors for osteoarthritis and these range from old age, belonging to the
female gender, being obese or overweight, excessive use of joints, weak muscles, low bone
density and lax joints. The progression of these problems causes osteoarthritis and more so,
when the joints are of the weight bearing type (Zhang, 2010). The severe pain caused by
osteoarthritis can often be the reason why patients seek treatment. It can restrict movement
and can lead to other problems, such as, obesity. The affected find it difficult to walk and the
pain makes climbing stairs very difficult. Treatment may include pain medication and many
patients may have to undergo a joint replacement surgery. Restriction of movement means
that the affected cannot remain socially active and this affects their mental health and well
being (Wright‐St Clair, et al., 2017) . In Fiona's case, she is in regular telephonic contact with
only her children. Having poor health literacy means that she cannot access medical care. She
finds herself incapable of booking an appointment with an ophthalmologist and an
orthopedician. She has little idea about how to go about it. There are many health services in
Australia tailored to the needs of remotely located elderly but one needs health literacy to be
able to avail those services. She is among the 60% Australians who lack adequate skills to
navigate the healthcare system (Bush, et al., n.d.). Policy options that are meant to solve the
problem include availability of simpler and easy to understand material, using multimedia to
spread awareness, making the health care providers aware of the problem of low levels of
health literacy and developing their professional skills and developing stronger partnerships
between primary health care services with not-for-profit organisations (Bush, et al., n.d.).
Fiona's major problem is that she has a poor social support system and so has not been
able to seek medical help for her weakening eye sight and the arthritis pain. She can rely on
occasional family support and can avail services of visiting nurse service, and community
support, because her loneliness and social isolation also need to be addressed . These
interventions will be able to help her access health services regularly and seek eye treatment

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and treatment for joint pain and knee pain. She cannot use public transport with ease due to
the pain but once the pain is managed through medication her mobility will improve. Fiona is
also a good candidate for receiving multimedia based education about the medication that she
will be prescribed by the clinicians, so that she can adhere to the prescription and not miss
doses (Ciciriello, et al., 2013). Another intervention that can be made is messaging through
the mobile phone. This can help the patient to carry out more effective self management of
chronic condition (de Jongh, et al., 2012). Widely known as mHealth interventions these have
been successfully used to help patients with self management of diabetes and hypertension
among other chronic diseases. Smartwatches have also been found to be effective in remote
monitoring of health parameters of patients. But the effectiveness remains to be tested for
people with osteoarthritis (King & Sarrafzadeh, 2018 ). Knee monitoring devices that are
wearable are being devised to instruct patients on exercise and for unobtrusive monitoring of
the condition of the knee. Thus the use of technology can be successfully done to advice,
monitor and help remotely located patients. But the help of social healthcare workers is also
required to support people in distressing health conditions so that they can seek advice about
medication, pain relief and access available resources from their homes. A mix of human and
technological intervention is required to help elderly patients like Fiona.
In conclusion, it is evident that elderly patients with low levels of health literacy need
help to access medical care so that they can get information about available health services.
Loneliness can be particularly distressing for individuals with chronic health conditions.
Added to it in Fiona's case she is remotely located and her movement is restricted due to
osteoarthritis- a painful and debilitating condition that needs prolonged treatment and self
management. Visits from healthcare workers can advice patients on the need to carry out eye
examination for eyesight issues and take timely treatment so that further complications can be
minimized. A mix of technological interventions can be used to improve the health literacy of

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patients and enable monitoring from a distance. Since addressing transport difficulties of
elderly patients is also a priority. It is important to impart some health literacy so that the
patient can self manage pain and chronic diseases through proper medication.

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References
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