A recent study from Case Western Reserve University has revealed a surprising insight into the lives and priorities of senior citizens receiving treatment at walk-in care clinics across the United States. While many might assume that health would dominate their concerns, the research found otherwise. Although maintaining health remains a significant priority, older adults rated “social activities and inclusiveness” as the most important aspect of their lives. This discovery challenges the common perception that medical or physical well-being automatically tops the list of older adults’ values. Conducted on a national scale, the study sheds light on the complexity of what truly matters to individuals aged sixty-five and above when they seek care at these outpatient facilities.
The research team analysed responses from roughly 388,000 patients who visited walk-in ambulatory care clinics between January 2021 and March 2024. These clinics, often located in neighbourhood pharmacies or community health centres, provide medical services for minor illnesses and injuries without requiring an appointment. Patients were asked a simple but revealing open-ended question: “What matters most to you?” The responses offered a profound glimpse into the mindset of ageing Americans. Nearly half of the participants identified social engagement—interactions, group activities, and feeling included within a community—as their top concern. Health followed at 21%, while independence and family togetherness ranked next at 17% and 10.5% respectively. Such figures point to a deeply human truth: older adults crave belonging and connection as much as, if not more than, they value physical well-being.
The study was co-led by Nicholas Schiltz, an assistant professor at Case Western Reserve University’s Frances Payne Bolton School of Nursing. Schiltz admitted that the findings came as a surprise, particularly given that the data were gathered from patients in acute-care settings. “I would have thought health would have been a little bit higher since this is an acute-care setting,” he explained, suggesting that the outcome reveals a broader truth about the emotional and social dimensions of ageing. Schiltz emphasised that older adults, like people of all ages, are multifaceted individuals whose lives cannot be reduced to a single factor such as physical health. Their identities and sense of purpose remain closely tied to community participation, independence, and family bonds.
The researchers designed the study to deepen understanding of patients’ priorities with the ultimate goal of improving health outcomes and personalising care. By identifying what matters most to older adults, clinicians can create more meaningful care plans that align with their values and lifestyles. For instance, if a patient values independence or social engagement above all else, care providers might adjust medication plans to reduce the risk of dizziness or falls that could limit mobility. They might also recommend physical therapy or assistive devices that enable patients to continue participating in community activities. In this way, healthcare becomes not merely a matter of treatment, but a partnership that respects the patient’s individuality and broader quality of life.
The study’s demographic data adds further depth to its findings. Among the respondents, nearly two-thirds were women, three-quarters identified as white, 5% as Black, 4.7% as Hispanic, and 2.7% as Asian. Interestingly, the researchers found that these differences in background had little bearing on what participants valued most. Across all races, sexes, and ethnic groups, social belonging remained the dominant concern. This universality underscores that the desire for inclusion and meaningful relationships transcends demographic boundaries. Whether in urban centres or rural towns, whether affluent or working-class, older adults across the country share a strikingly similar vision of what gives their lives purpose.
Mary Dolansky, the Sarah C. Hirsh Professor at the Frances Payne Bolton School of Nursing and co-leader of the study, placed the research within a broader national movement toward age-friendly health systems. She noted that the findings align with the mission of The John A. Hartford Foundation’s Age-Friendly Health Systems initiative, which aims to ensure that all older adults receive evidence-based, holistic care. Dolansky highlighted that effective elderly care must extend beyond physical treatment to encompass safe medication practices, assessments of mental health, cognitive function, and mobility. With the population ageing rapidly, she stressed the urgency of adapting the healthcare system to meet these evolving needs. The Case Western study thus serves not only as an academic contribution but as a call to action: to view older adults not just as patients with medical conditions, but as individuals with complex emotional, social, and familial lives deserving of dignity and understanding.
More information: Nicholas Schiltz et al, Patient-Centered Priorities for Older Adults in Ambulatory Care, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.35769
Journal information: JAMA Network Open Provided by Case Western Reserve University
