The aim of this qualitative systematic review was to report a synthesis of older persons’ perceptions of health, ill health, and their community health care needs. The review questions were what characterizes older persons’ perceptions of health and ill health? and what are their community health care needs? Ten studies were identified in a systematic search for relevant qualitative papers published between January 2000 and January 2013 in the following electronic databases: PubMed, EBSCOhost/Academic Search Premier, and CINAHL. Publications were evaluated for quality, and a thematic analysis was performed. Two main themes were interpreted on a higher level: reconciliation with how life has become: and desire to regain their identity and sense of self-worth despite disability. Two themes emerged: creating meaning led to the experience of being valued in health care and society and a mental struggle to regain independence with the help of caregivers. Of special interest is the finding of perceptions related to the fear of becoming dependent on caregivers as well as the sorrow and pain caused by encountering caregivers who did not understand their desire to create meaning in their lives or their struggle for autonomy and independency. 1. Introduction The concept of health has been characterised in many ways since the World Health Organisation (WHO) defined it as a state of physical, mental, and social well-being [1]. It is often described in holistic terms, including physical, psychological, social, cultural, and existential values [2–4]. The focus of the WHO [5] on increasing life expectancy has led to a marked growth in the older population globally, both in relative and absolute terms. This is true not only of high income countries but also of the rest of the world [5]. The increasing number of elderly persons will challenge global, national and local resources in the future [6]. The focus on active aging has made it a matter of increasing urgency to identify ways of maintaining elderly persons’ health and well-being [7]. The health of such persons should not only be viewed in terms of disease prevalence or absence of illness but rather understood as two sides of the same coin. Older people’s health is often associated with functional impairment, as physical functioning and psychosocial well-being are closely related [8–10]. Dependency on care has been negatively associated with health among older people [11–13]. Strandberg et al. [13] revealed that dependency on care is a struggle against worthlessness, powerlessness, loneliness, and failure to obtain
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