Standardization and Individualization in Care for the Elderly: Proactive Behavior Through Individualized Standardization

ABSTRACT

There are two mega-trends in society as well as in the health care system: standardization and individualization. Our hypothesis is that these trends are not fully compatible. They are the reason for many conflicts in health care and in the care of the elderly. On the one hand, evidence-based standards of care can help to enhance disability-free life expectancy. On the other hand, these standards constrain the choice of the patient and, thus, proactive behavior. Guidelines and disease management programs are examples of the trend toward standardization; shared decision-making, case management and personalized medicine are examples of the trend towards individualization. We show potential conflict lines between both trends and we suggest “individualized standardization of care” as a possible solution to the underlying conflict. The hypothesis is that this combination of both trends helps the older patient to live a proactive life on the basis of evidence-based medicine and health care principles. This combination probably enhances disability-free life expectancy.

Keywords:

Standardization, individualization, proactive behavior, care, elderly, shared decision making, guideline.