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Daily Illness Characteristics and Health Care Decisions of Older People

University of Michigan

Hiroko Akiyama

University of Michigan

William Rakowski

Brown University

Although investigations of health care decision making typically deal with patterns of health service use, increasing attention has focused on lay- and self-care actions in response to illness symptoms. This study examined the health care actions of a community sample of 142 older adults, who recorded illness symptoms and corresponding health care actions in daily health diaries for a 14-day period. Self-treatment and no-action decisions were found to be the most frequent response to illness symptoms. Professional-care decisions were associated with greater health care need, such as multiple symptoms and increased pain. Lay-care decisions were significantly related to symptoms of shorter duration. Women were also more likely than men to self-treat their illness symptoms. Results suggest that older people deal with a greater number of recurrent chronic symptoms than previously thought and that they make most treatment decisions without consulting their doctors or other health care providers. This investigation underscores the importance of a prospective diary methodology for studying the daily complex ities of chronic illness experiences and for validating and conducting useful interventions.

Journal of Applied Gerontology, Vol. 10, No. 2, 169-184 (1991)
DOI: 10.1177/073346489101000204


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