The extent of individual responsibility for an independent old age

Encouragement of a degree of personal responsibility for the maintenance of health by individuals and communities is being increasingly advocated by planners of health care. With the increasing numbers of people reaching old age it is particularly desirable that individuals be made aware of potential measures that may ensure a reasonably independent old age. In the course of a study to identify the defining characteristics of referred geriatric patients in a teaching hospital, a number of recurring factors emerged that seemed to favour the retention of independence among the subjects studied as controls. These were adequate retirement planning, the timely development of satisfying interests, the prior adoption of a healthy lifestyle, the sensible use of health services and the presence of adequate family and community support systems. Six cases are described to illustrate the presence or absence of such factors, and these are discussed against the background of the respective degrees of responsibility to be expected of the individual and of society in securing and maintaining independence in old age.