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Chapter 59 - Health Literacy

from Section IV - Principles of Care for the Elderly

Published online by Cambridge University Press:  30 June 2022

By
Lisa R. Smith ,
Terri Ottosen ,
Annette Beyea  and
Cristine B. Henage
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

This chapter focuses on resources, strategies, and interventions when working with older adults with low health literacy. Integrating practical ways of engaging this population can enhance and improve older adults’ health status, and enhance the interaction and relationships with health-care providers. As patients are asked to take a more active role in the management of their health, enabling participation and better communication, the patients’ involvement can have a dramatic effect in improving health outcomes and patient satisfaction. Health professionals can encourage clear health communication to promote the overall health and well-being of older adults.

Engaging and working with older adults with low health literacy is critical to improving health outcomes. For those with low health literacy, it's important to ensure health messages, both verbal and written, are communicated clearly so that patients can understand what they need to do, in order to achieve better health and make informed decisions about their care. Older adults may be more hesitant to ask questions of their health providers, or lack the skills to find, evaluate, and utilize health information online. Other factors, such as physical, cognitive, and social age-related changes, can also impact older adults’ ability to understand and process health information.

Keywords

health literacyolder adultsagingpatient educationpatient-physician communicationpatient engagementhealth outcomeshealth disparitiescognitionmedication adherence
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 716 - 726
Publisher: Cambridge University Press
Print publication year: 2022

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References

Ratzan, SC, Parker, RM. Introduction. In: Selden, CR, Zorn, M, Ratzan, SC, Parker, RM, eds. National Library of Medicine Current Bibliographies in Medicine: Health Literacy (CBM 2000–1). Bethesda, MD: National Institutes of Health, 2000.Google Scholar
Federal Register: Solicitation for Written Comments on an Updated Health Literacy Definition for Healthy People 192030. www.federalregister.gov/documents/2019/06/04/2019-11571/solicitation-for-written-comments-on-an-updated-health-literacy-definition-for-healthy-people-2030.Google Scholar
Coleman, C, Kurtz-Rossi, S, McKinney, J, Pleasant, A, Rootman, I, Shohet, L. The Calgary Charter on Health Literacy: Rationale and Core Principles for the Development of Health Literacy Curricula. Montreal, Quebec, Canada: The Centre for Literacy, 2010.Google Scholar
National Assessment of Adult Literacy (NAAL) – NAAL Factsheets – Overview. https://nces.ed.gov/naal/fct_overview.asp.Google Scholar
Berkman, ND, Sheridan, SL, Donahue, KE, Halpern, DJ, Crotty, K. Low health literacy and health outcomes: An updated systematic review. Ann Intern Med. 2011 (Jul. 19); 155(2):97–107.Google Scholar
Berkman, ND, Sheridan, SL, Donahue, KE, Halpern, DJ, Viera, A, Crotty, K, et al. Health literacy interventions and outcomes: An updated systematic review. Evid Rep Technol Assess (Full Rep). 2011 (Mar.); (199):1–941.Google Scholar
Kobayashi, LC, Wardle, J, Wolf, MS, von Wagner, C. Aging and functional health literacy: A systematic review and meta-analysis. J Gerontol B, Psychol Sci Soc Sci. 2016 (May); 71(3):445–457.Google Scholar
MacLeod, S, Musich, S, Gulyas, S, Cheng, Y, Tkatch, R, Cempellin, D, et al. The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults. Geriatr Nurs. 2017 (Jan. 11); 38(4):334–341.Google Scholar
Shenkman, L. Health literacy and health outcomes of adults in the United States: Implications for providers. Internet Journal of Allied Health Sciences and Practice. 2018 (Oct. 3); 16(4).Google Scholar
Noblin, AM, Rutherford, A. Impact of health literacy on senior citizen engagement in health care IT usage. Gerontol Geriatr Med. 2017 (Dec.); 3:2333721417706300.Google Scholar
McNaughton, CD, Cawthon, C, Kripalani, S, Liu, D, Storrow, AB, Roumie, CL. Health literacy and mortality: A cohort study of patients hospitalized for acute heart failure. J Am Heart Assoc. 2015 (Apr. 29); 4(5).Google Scholar
Health Literacy and the Older Adult – Clinical Advisor. www.clinicaladvisor.com/home/features/clinical-features/health-literacy-and-the-older-adult.Google Scholar
White, ML, Verdusco, LM. Communicating with older adults. Home Healthc Now. 2018; 36(3):181–184.Google Scholar
National Institute on Aging. Tips for Improving Communication with Older Patients. www.nia.nih.gov/health/tips-improving-communication-older-patients.Google Scholar
Kim, HN. Understanding of how older adults with low vision obtain, process, and understand health information and services. Inform Health Soc Care. 2019 (Jan.); 44(1):70–78.Google Scholar
Mullen, RJ, Curtis, LM, O’Conor, R, Serper, M, McCarthy, D, Bailey, SC, et al. Visual acuity, literacy, and unintentional misuse of nonprescription medications. Am J Health Syst Pharm. 2018 (May 1); 75(9):e213–e220.Google Scholar
Kobayashi, LC, Smith, SG, O’Conor, R, Curtis, LM, Park, D, von Wagner, C, et al. The role of cognitive function in the relationship between age and health literacy: A cross-sectional analysis of older adults in Chicago, USA. BMJ Open. 2015 (Apr. 23); 5(4):e007222.CrossRefGoogle ScholarPubMed
Han, SD, Boyle, PA, James, BD, Yu, L, Bennett, DA. Poorer financial and health literacy among community-dwelling older adults with mild cognitive impairment. J Aging Health. 2015 (Sep.); 27(6):1105–1117.CrossRefGoogle ScholarPubMed
Chesser, AK, Keene Woods, N, Smothers, K, Rogers, N. Health literacy and older adults: A systematic review. Gerontol Geriatr Med. 2016 (Dec.); 2:1–13.Google Scholar
Lee, JK, Son, Y-J. Gender differences in the impact of cognitive function on health literacy among older adults with heart failure. Int J Environ Res Public Health. 2018 (Dec. 1); 15(12).Google Scholar
Liu, YB, Chen, YL, Xue, HP, Hou, P. Health literacy risk in older adults with and without mild cognitive impairment. Nurs Res. 2019; 68(6):433–438.Google Scholar
Serper, M, Patzer, RE, Curtis, LM, Smith, SG, O’Conor, R, Baker, DW, et al. Health literacy, cognitive ability, and functional health status among older adults. Health Serv Res. 2014 (Aug.); 49(4):1249–1267.CrossRefGoogle ScholarPubMed
Grace, S, Horstmanshof, L. A realist evaluation of a regional Dementia Health Literacy Project. Health Expect. 2019 (Jan. 2); 22(3):426–434.Google Scholar
Jiang, Y, Sereika, SM, Lingler, JH, Tamres, LK, Erlen, JA. Health literacy and its correlates in informal caregivers of adults with memory loss. Geriatr Nurs. 2018; 39(3):285–291.Google Scholar
Geboers, B, Reijneveld, SA, Jansen, CJM, de Winter, AF. Health literacy is associated with health behaviors and social factors among older adults: Results from the LifeLines Cohort Study. J Health Commun. 2016 (Sep. 23); 21(suppl. 2):45–53.Google Scholar
Mosqueda, L, Fiatarone Singh, M, Reichel, W. Reichel’s Care of the Elderly: Clinical Aspects of Aging, 7th edition. Busby-Whitehead, J, Arenson, C, Durso, S, Swagerty, D, Mosqueda, L, Fiatarone Singh, M, et al., eds. Cambridge: Cambridge University Press, 2016.Google Scholar
Federman, AD, Wolf, MS, Sofianou, A, Martynenko, M, O’Connor, R, Halm, EA, et al. Self-management behaviors in older adults with asthma: Associations with health literacy. J Am Geriatr Soc. 2014 (May); 62(5):872–879.Google Scholar
Huang, CH, Lai, Y-C, Lee, YC, Teong, XT, Kuzuya, M, Kuo, K-M. Impact of health literacy on frailty among community-dwelling seniors. J Clin Med. 2018 (Nov. 26); 7(12).CrossRefGoogle ScholarPubMed
Goeman, D, Conway, S, Norman, R, Morley, J, Weerasuriya, R, Osborne, RH, et al. Optimising health literacy and access of service provision to community dwelling older people with diabetes receiving home nursing support. J Diabetes Res. 2016 (Sep. 7); 2016:2483263.Google Scholar
Picetti, D, Foster, S, Pangle, AK, Schrader, A, George, M, Wei, JY, et al. Hydration health literacy in the elderly. Nutr Healthy Aging. 2017 (Dec. 7); 4(3):227–237.CrossRefGoogle ScholarPubMed
Fernandez, DM, Larson, JL, Zikmund-Fisher, BJ. Associations between health literacy and preventive health behaviors among older adults: Findings from the health and retirement study. BMC Public Health. 2016 (Jul. 19); 16:596.Google Scholar
Smith, SG, O’Conor, R, Curtis, LM, Waite, K, Deary, IJ, Paasche-Orlow, M, et al. Low health literacy predicts decline in physical function among older adults: Findings from the LitCog cohort study. J Epidemiol Community Health. 2015 (May); 69(5):474–480.Google Scholar
Cutilli, CC. Health literacy in geriatric patients: An integrative review of the literature. Orthop Nurs. 2007 (Feb.); 26(1):43–48.Google Scholar
Bennett, JS, Boyle, PA, James, BD, Bennett, DA. Correlates of health and financial literacy in older adults without dementia. BMC Geriatr. 2012 (Jun. 12); 12:30.Google Scholar
Ho, M-H, Wang, C-H, Joo, JY, Chang, H-CR, Chang, C-C, Liu, MF. Predictors of emergency department use among community-dwelling older adults. J Gerontol Nurs. 2019 (May 1); 45(5):31–38.Google Scholar
Nouri, SS, Barnes, DE, Volow, AM, McMahan, RD, Kushel, M, Jin, C, et al. Health literacy matters more than experience for advance care planning knowledge among older adults. J Am Geriatr Soc. 2019 (Oct.); 67(10):2151–2156.Google Scholar
Huang, H-Y, Kuo, K-M, Lu, I-C, Wu, H, Lin, C-W, Hsieh, M-T, et al. The impact of health literacy on knowledge, Attitude and decision towards hospice care among community-dwelling seniors. Health Soc Care Community. 2019 (Jun. 18); 27(5):e724–e733.Google Scholar
Paasche-Orlow, MK, Wolf, MS. Evidence does not support clinical screening of literacy. J Gen Intern Med. 2008 (Jan.); 23(1):100–102.Google Scholar
Weiss, BD. How to bridge the health literacy gap. Fam Pract Manag. 2014 (Feb.); 21(1):14–18.Google Scholar
DeWalt, DA, Broucksou, KA, Hawk, V, Brach, C, Hink, A, Rudd, R, et al. Developing and testing the health literacy universal precautions toolkit. Nurs Outlook. 2011 (Apr.); 59(2):85–94.Google Scholar
Hersh, L, Salzman, B, Snyderman, D. Health literacy in primary care practice. Am Fam Physician. 2015 (Jul. 15); 92(2):118–124.Google Scholar
Morris, NS, MacLean, CD, Chew, LD, Littenberg, B. The Single Item Literacy Screener: Evaluation of a brief instrument to identify limited reading ability. BMC Fam Pract. 2006 (Mar. 24); 7:21.Google Scholar
Keene Woods, N, Chesser, AK. Validation of a single question health literacy screening tool for older adults. Gerontol Geriatr Med. 2017 (Dec.); 3:2333721417713095.Google Scholar
Ylitalo, KR, Meyer, MRU, Lanning, BA, During, C, Laschober, R, Griggs, JO. Simple screening tools to identify limited health literacy in a low-income patient population. Medicine. 2018 (Mar.); 97(10):e0110.Google Scholar
Parnell, TA, McCulloch, EC, North Shore Long Island Jewish Health System, et al. Health literacy as an essential component to achieving excellent patient outcomes. NAM Perspectives. 2014 (Jan. 28); 4(1).Google Scholar
Huang, Y-M, Shiyanbola, OO, Smith, PD, Chan, H-Y. Quick screen of patients’ numeracy and document literacy skills: The factor structure of the Newest Vital Sign. Patient Prefer Adherence. 2018 (May 17); 12:853–859.Google Scholar
Shealy, KM, Threatt, TB. Utilization of the newest vital sign (NVS) in practice in the United States. Health Commun. 2016; 31(6):679–687.Google Scholar
Weiss, BD, Mays, MZ, Martz, W, Castro, KM, DeWalt, DA, Pignone, MP, et al. Quick assessment of literacy in primary care: The newest vital sign. Ann Fam Med. 2005 (Dec.); 3(6):514–522.Google Scholar
Fang, G, Bailey, SC, Annis, IE, Paasche-Orlow, MK, Wolf, MS, Martin, LT, et al. Effects of estimated community-level health literacy on treatment initiation and preventive care among older adults with newly diagnosed diabetes. Patient Prefer Adherence. 2020 (Jan. 7); 14:1–11.Google Scholar
Fang, B, University of North Carolina at Chapel Hill. National Health Literacy Mapping to Inform Health Care Policy. Health Literacy Data Map, 2014. http://healthliteracymap.unc.edu.Google Scholar
Kessels, RPC. Patients’ memory for medical information. J R Soc Med. 2003 (May); 96(5):219–222.Google Scholar
Health literacy, National Institutes of Health (NIH). www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/health-literacy.Google Scholar
Kopera-Frye, K, ed. Health Literacy Among Older Adults. New York: Springer Publishing Company, 2016.Google Scholar
Everyday Words for Public Health Communication, 2016. www.cdc.gov/healthcommunication/everydaywords.Google Scholar
Brega, AG, Bernard, J, Mabachi, NM, Weiss, BD, DeWalt, DA, Brach, C, et al. Health Literacy Universal Precautions Toolkit, 2nd edition. Agency for Healthcare Research & Quality, 2015. www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2.html.Google Scholar
Jiggins, K. A content analysis of the meaningful use clinical summary: Do clinical summaries promote patient engagement? Prim Health Care Res Dev. 2016 (May); 17(3):238–251.Google Scholar
Weiss BD. Health Literacy and Patient Safety: Help Patients Understand: Manual for Clinicians, 2007; 29–40. www.partnershiphp.org/Providers/HealthServices/Documents/Health%20Education/CandLToolKit/2%20Manual%20for%20Clinicians.pdf.Google Scholar
Susło, R, Paplicki, M, Dopierała, K, Drobnik, J. Fostering digital literacy in the elderly as a means to secure their health needs and human rights in the reality of the twenty-first century. Fmpcr. 2018; 20(3):271–275.Google Scholar
Leroy, G, Kauchak, D. A comparison of text versus audio for information comprehension with future uses for smart speakers. JAMIA Open. 2019 (Jul.); 2(2):254–260.Google Scholar
Computer and Internet Training for Health Information with Rural Older Adults – ProQuest. https://search.proquest.com/docview/2024633588?pq-origsite=gscholar.Google Scholar
Ottosen, T, Mani, NS, Fratta, MN. Health information literacy awareness and capacity building: Present and future. IFLA Journal. 2019 (Jul. 10); 45(3):207–215.Google Scholar
Price-Haywood, EG, Harden-Barrios, J, Ulep, R, Luo, Q. eHealth literacy: Patient engagement in identifying strategies to encourage use of patient portals among older adults. Popul Health Manag. 2017 (Apr. 6); 20(6):486–494.Google Scholar
Irizarry, T, Shoemake, J, Nilsen, ML, Czaja, S, Beach, S, DeVito Dabbs, A. Patient portals as a tool for health care engagement: A mixed-method study of older adults with varying levels of health literacy and prior patient portal use. J Med Internet Res. 2017 (Mar. 30); 19(3):e99.Google Scholar
Azevedo, RFL, Morrow, D, Graumlich, J, Willemsen-Dunlap, A, Hasegawa-Johnson, M, Huang, TS, et al. Using conversational agents to explain medication instructions to older adults. AMIA Annu Symp Proc. 2018 (Dec. 5); 2018:185–194.Google Scholar
Magsamen-Conrad, K, Dillon, JM, Billotte Verhoff, C, Faulkner, SL. Online health-information seeking among older populations: Family influences and the role of the medical professional. Health Commun. 2019; 34(8):859–871.Google Scholar
Rasu, RS, Bawa, WA, Suminski, R, Snella, K, Warady, B. Health literacy impact on national healthcare utilization and expenditure. Int J Health Policy Manag. 2015 (Aug. 17); 4(11):747–755.Google Scholar
Social Determinants of Health, Healthy People, 2020. www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health.Google Scholar

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