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In common with orphanages, mental hospitals and military barracks, they were "total institutions", preoccupied with minimising risk and facilitating staff routines at the expense of granting adults autonomy and self-respect.
According to Cunha et. al. (2005), important basic life skills are cooperation with peers and adults, autonomy, meaning making, creativity, problem solving, and persistence.
However, this program does not promote the older adults' autonomy because the older adults are passive [ 24].
In genetic testing for adults, autonomy of choice is a key principle; people must decide for themselves whether they want to know their genetic make-up or predisposition for disease.
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In Maynard's case, this last exertion of control — the desire to set the scene for her death — is a moving manifestation of adult autonomy only very recently won, all the more poignant for the way in which it parallels Maynard's recent, more generationally predictable incarnation as a bride.
Instead of promoting the idea of college as a transition from the shelter of the family to adult autonomy and responsibility, universities like Yale have given in to the implicit notion that they should provide the equivalent of the home environment.
Such unintended consequences might include stigmatisation of 'sick' people, where the fact of being ill becomes a personal moral failing, or where the experience of feeling forced to follow a regimen may actually result in a kind of rebellious non-compliance as a reassertion of personal and adult autonomy [ 17] [see also [ 18, 19]].
In respecting an adult's autonomy an adult may enter trials that carry risks and consciously accept those risks because of advantages to others (perhaps the community of those who have the disease), or if they have an inherited disease, benefits for their children or grandchildren.
Non-profit run shelter programs that give adults some autonomy (like the ability to shop for and cook their own food and take escorted trips into nearby towns) and even electronic monitoring programs have both been successful in maintaining track of people awaiting their immigration trials while affording them the dignity every human being deserves.
However, we focus primarily on envisioning desired situations wherein older adults have autonomy and independence; are easily able to manage their health and wellness needs; have rich and rewarding opportunities for social connectedness, personal growth, continued life purpose, and overall high quality of life.
To investigate whether the geriatric care model accomplishes the transition we intended, we will explore how older adults experience autonomy, how older adults and health care professionals experience the way care is coordinated during the intervention, and the extend to which the geriatric care model manages to be proactive in indentifying previously undetected health problems and care needs.
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