Care delivery approaches and seniors' independence

Fostering independence amongst people over 65 years of age, over 80 per cen t of whom have medical conditions, presents many challenges to policy perso nnel, program planners, and service providers, as physical, social, and psy chological dimensions of independence must all be considered. This paper pr esents a systematic literature review and synthesis of 65 rigorous, compreh ensive research papers selected from 238 published studies on care delivery approaches relevant to promoting the independence of older persons. This e vidence suggests the merits of exercise and health promotion programs for a ll seniors, and in-home geriatric health care management and fall preventio n programs for frail older persons. Findings also indicate the need for mor e attention to policy on assistive devices, and the need for more research on the effectiveness of public health programming, on strategies to enhance preventive medical care, and on psychosocial factors which affect seniors' self-efficacy.