Navigating the Complexity of Elderly Self-care: A Narrative Review of Barriers and Facilitators in Chronic Disease Management

Ebereghwa EM; Archibong F; Ogunjobi OT

doi:10.61386/imj.v19i4.1385

Authors

Ebereghwa EM Department of Family Medicine, Delta State University, P.M.B. 01, Abraka, Delta State, Nigeria
Archibong F Department of Family Medicine, University of Calabar Teaching Hospital, Cross River, Nigeria
Ogunjobi OT Department of Community Medicine, Leadcity University, Ibadan, Nigeria

DOI:

https://doi.org/10.61386/imj.v19i4.1385

Keywords:

Barriers and Facilitators, Chronic disease, Elderly, Narrative review, Self-care

Abstract

Context: Global life expectancy is rising, shifting the burden of chronic disease management largely to patient self-care. For the elderly population, independent care is complex and highly susceptible to age-related changes, yet a comprehensive understanding of what hinders or promotes this process remains fragmented.

Objective: This review aims to identify, categorize and analyze the multi-dimensional barriers and facilitators influencing chronic disease self-care among adults aged 60 and older.

Methods: A comprehensive search of databases including PubMed, PsycINFO and Google Scholar was conducted for English language peer-reviewed articles published between 2016 and 2026. A narrative synthesis framework was applied to extract, cross-reference and map critical structural, social, and personal themes.

Results: An initial 974 records were retrieved; 586 duplicates were removed and 466 were excluded during title and abstract screening. The remaining 122 full-text manuscripts underwent evaluation, yielding a final cohort of 42 high-quality, mixed-design studies for thematic synthesis after 74 were excluded for methodological variations.

Discussion: The intersection of physical decline, cognitive limitations and multimorbidity forms a “vulnerability triad”, complicating self-care as medical needs outpace patient capacity. While cognitive ageing and low health literacy hinder adherence, robust social networks and self-efficacy facilitate it. Digital interfaces provide essential external cognitive support but require age-inclusive design and human-led onboarding.

Conclusion: Elderly self-care is dictated by a delicate balance between personal limitations and external support systems. Improving elderly self-care and health outcomes requires a shift to holistic, person-centered models. Healthcare providers must actively mitigate physical barriers while leveraging family-centered support frameworks.