Fostering independence amongst people over 65 years of age, over 80% of whom have medical conditions, presents many challenges to policy personnel, program planners, and service providers, as physical, social, and psychological dimensions of independence must all be considered. This paper presents a systematic literature review and synthesis of 65 rigorous, comprehensive research papers selected from 238 published studies on care delivery approaches relevant to promoting the independence of older persons. This evidence suggests the merits of exercise and health promotion programs for all seniors, and in-home geriatric health care management and fall prevention programs for frail older persons. Findings also indicate the need for more attention to policy on assistive devices, and the need for more research on the effectiveness of public health programming, on strategies to enhance preventive medical care, and on psychosocial factors which affect seniors' self-efficacy.

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