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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 community-dwelling 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.

This chapter focuses on the proactive adaptations that patients can undertake to successfully navigate today's increasingly complex health care system. Our report urges a paradigm shift in patient and family expectations, moving from expectations of “patiently” awaiting good care to taking responsibility for finding and getting optimal health care services. We consider the role that key informal health care partners (caregivers) can play in facilitating these proactive adaptations. Based on extensive participant observations by the authors during recent illness episodes, we present a framework for planning and implementing proactive adaptations which can improve the health care that consumers receive.

This paper examines the health care experiences of older adults over a five-year period, including continuity in care, changes in health insurance coverage, and satisfaction with care.

Face-to-face interviews were conducted annually with 415 older adults (mean age = 84, range = 72–105), 100 of whom were originally health maintenance organization (HMO) subscribers and 315 of whom were receiving fee-for-service care. Several predictors of health care experiences were examined, including personal characteristics, health status and health care variables. Coverage type (HMO or fee-for-service) was the most consistent predictor. HMO subscribers were more likely than fee-for-service recipients to experience changes in insurance (both negative and positive changes) and discontinuity in physician care, although satisfaction with care did not vary among HMO and non-HMO members. Two-thirds of HMO subscribers and nearly one-third of fee-for-service recipients reported changes in insurance coverage over the five-year study period. In terms of perspectives on HMO care, the most frequently mentioned advantage of HMO care among those in HMOs was diminished costs, while fee-for-service subscribers did not believe there were any advantages to being in an HMO. Those not in HMOs viewed loss of physician choice and poor quality care as major disadvantages of HMOs. Results of this study demonstrate that older adults commonly experience changes in their health care coverage and physician care. They adapt to these changes through positive appraisals of the type of case they receive.

This study aimed to identify which positive psychological factors are associated with the mental health of older adult retirees. Positive psychology is an emerging discipline of psychology. The study and identification of such factors could lead to increased mental health and lower stress levels of individuals (Ho et al., 2014; Abbas et al., 2019).

The authors searched the following electronic databases: Web of Science Core Collection and Scopus. Thematic synthesis was used for analysis. Database search resulted in the recruitment of 948 articles; after the screening process, only 7 articles were left for further analysis.

Thematic synthesis of resulting articles from systematic literature review revealed that “staying active after retirement, participation in social activities, volunteering, and presence of loved ones” are positive psychological factors that are positively associated with the mental health of older adult retirees. A few positive psychological factors and their association with the mental health of older adult retirees have been examined. Other positive psychological factors and their association with the mental health of older adult retirees are yet to be investigated in future research.

First, many studies have investigated meaning and purpose in life, relationships or having intimacy, well-being, transcendence, flow or engagement, spirituality and flourishing (pleasant life, engaged life and meaningful life, relationship and achievement) (LeBon, 2014). However, many other positive psychological constructs need to be studied yet in this age group examples include wisdom, courage, mindfulness, forgiveness, resilience, emotional intelligence, hope and humor. Second, there is need of theory in the field of successful aging with respect to the positive psychology. Third, which factors negatively contributed toward the mental health of older adult could be another area of future systematic literature review. Finally, role of culture needs to be examined with reference to which positive psychological factor could be important in a specific given cultural context.

The findings of the current research will be useful for clinical psychologist, counselors and gerontologists to understand which factors positively contributed toward the mental health of older adult retirees, which in turn will help to improve mental health of older adult retirees. Findings of the present study set grounds for future research in the field of gerontology in specific cultural context. The findings of this study have added to scientific body of existing literature. Better understanding of retirement can lead to increase in use of positive intervention-based programs for retirees that can facilitate them with life after retirement.

Policymaker working on the well-being of older adult retirees can take help from this study’s evidence-based findings for developing any policy.

Systematic literature review consolidated the existing literature review on the present topic of research. This systematic literature review highlighted factors that are associated with the enhanced mental health of older adults’ retirees. Furthermore, findings revealed the important gap in literature that is many positive psychological constructs are need to be studied yet in this age group examples includes wisdom, courage, mindfulness, forgiveness, resilience, emotional intelligence, hope and humor. Hence, this study has implications for future research.