Older adults and autonomy in acute care: increasing patients' independence and control during hospitalization.

In a grounded theory study of the experience and actions of hospitalized older adults, autonomy emerged as a major focus, particularly during the last phase of hospitalization. Autonomy, defined in the derived theory as older adults' freedom and ability to act on their own behalf, has two components: independence (the physical ability to act) and control (the ability to make decisions on one's own behalf). Being in the hospital threatens the autonomy of older adults. This article describes changes in the autonomy of older adults throughout hospitalization and makes recommendations for improving their autonomy through acute care hospital system redesign.