The growing demand for more long-term care (LTC) services for older adults does not appear to be matched by an investigation of the causes of the demand. Older adults are immensely diverse and may have compromised function due to a combination of causes, including normal aging, psychosocial and environmental conditions, new or existing chronic illness, acute disease and the adverse effects of drugs and other treatments. Unfortunately, most health-care professionals (HCPs) lack gerontological preparation and may therefore be unable to understand and meet older adults' needs or to critique the quality of their care and comprehend its consequences. HCPs who provide uninformed care may erode older adults' holistic health and contribute to their decline into LTC. A major shortfall in older adults' care is mistaken assumptions about what physical and mental changes are normal with aging and a subsequent lack of attention to the underlying causes of signs and symptoms. Gerontologically uninformed pharmacological practices may also harm older adults' health and increase the need for LTC. Hospitalization itself is a major risk for older adults, often unnecessarily precipitating a permanent move to LTC. The medical model, ageism and other socio-political conditions all put constraints on the care of older adults and promote LTC over health promotion and protection. Ways to enrich older adults' care include expert gerontological attention for those now in LTC, stakeholder inclusion in decision-making about gerontological care and policy, education for all stakeholders including HCPs (both practising and students), communication with members of Parliament and the public about gerontological needs, administrative support, a broader model of care, gerontological standards of care and comprehensive programs of gerontological care.
Comment In: Can Nurse. 2005 Oct;101(8):4-516295354