As medical models become more ubiquitous in developing strategies to provide long term care services and support (LTSS) we need to ask if these models adequately account for sources of diversity and disadvantage that impact access to and use of services by older adults.

Medical models typically focus on categorizing information about the individual in order to clearly define current health status and appropriate treatment. Any individual, however, reflects the sum of their life experiences.

Managed care systems must go beyond current medicalized models of care and integrate not only the social determinants of health but the whole person – including background, culture, and life experience - to fully serve the coming generation of older persons.

– Glicksman, Rodriguez, and Liebman

Therefore, this medicalization approach can miss key factors in determining health outcomes including social determinants of health.

Just as importantly, this approach can miss issues of values, beliefs, and assumptions that older adults can bring into the encounter with service providers.

This issue is especially important when dealing with older migrant communities. Beliefs and attitudes shaped in their place of origin, as well as the migration experience, can influence levels of trust and resulting decisions regarding the use of LTSS.

We need to integrate an understanding of how these beliefs and attitudes affect decision making into any model designed to improve the lives of older persons.