What matters most to senior citizens? Not what you might think

CLEVELAND—You might expect that senior citizens treated at walk-in care clinics would say what matters most to them is their health.

But you’d be wrong.

No question, their health is right up there. But “social activities and inclusiveness” are an even bigger priority, according to a new study by researchers at Case Western Reserve University.

Then comes health, followed by independence and family togetherness as what’s most important to them. That’s based on responses from about 388,000 patients aged 65 and older nationally at walk-in ambulatory care clinics. (Walk-in care clinics provide outpatient medical services for minor illnesses and injuries without an appointment, such as those at your local drugstore.)

Nicholas Schiltz, an assistant professor at Case Western Reserve’s Frances Payne Bolton School of Nursing, who co-led the research, said they did find the results a bit surprising.

“I would have thought health would have been a little bit higher since this is an acute-care setting,” he said. “But I think it just shows that older adults—like everybody else— are very complex and have other needs that are just as much a priority.”

The purpose of studying the question is to improve patient care and health outcomes by better understanding their preferences and goals.

The clinics want to align a care plan to what matters most to the patient, Schiltz said. So, if priorities are independence or being engaged in activities, they may tailor the medications to reduce the risk of falls or they may prescribe mobility aids.

The study, published Oct. 6 by JAMA Network Open, used electronic health records from a national network of walk-in ambulatory care clinics—about 900 clinics in 35 states. Patients 65 and older who had in-person clinical treatment between January 2021 and March 2024 were asked the open-ended question “What matters most to you?”

Almost half listed social activities and inclusiveness, followed by health (21%), independence (17%) and family togetherness (10.5%).

Demographically, of the respondents, nearly two-thirds were women, three-fourths were white, 2.7% Asian, 5% Black and 4.7% Hispanic. The researchers found that the respondents’ priorities didn’t vary much by sex, race or ethnicity.

“This is important work that is a part of The John A. Hartford Foundation Age-Friendly Health Systems movement across the country to ensure all older adults receive evidence-based care,” said Mary Dolansky, the Sarah C. Hirsh Professor at the nursing school, who co-led the study. “In addition to what matters, older adult care integrates other important dimensions of aging, such as receiving safe medications, assessments on depression and brain health and mobility. The population is aging, and we need to make sure all older adults receive evidence-based quality healthcare.”

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As one of the fastest-growing research universities in the United States, Case Western Reserve University is a force in career-defining education and life-changing research. Across our campus, more than 12,000 students from around the world converge to seek knowledge, find solutions and accelerate their impact. They learn from and collaborate with faculty members renowned for expertise in medicine, engineering, science, law, management, dental medicine, nursing, social work, and the arts. And with our location in Cleveland, Ohio—a hub of cultural, business and healthcare activity—our students gain unparalleled access to academic, research, clinical and entrepreneurial opportunities that prepare them to join our network of more than 125,000 alumni worldwide. Visit case.edu to see why Case Western Reserve University is built for those driven to be a force in the world.