International Journal of Health Sciences & Research (www.ijhsr.org) 301 Vol.5; Issue: 7; July 2015 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Health Literacy Challenges Among Older Adult Orthopaedic Rehabilitation Patients Allison Kabel, Madison Mazzier, Julia Russo, Sean Joy University of Missouri, Columbia. Corresponding Author: Allison Kabel Received: 07/05/2015 Revised: 26/05/2015 Accepted: 02/06/2015 ABSTRACT The aim of this study was to discover the health literacy based gaps, barriers, and challenges associated with recovery from knee replacements in middle to older adults. Qualitative case studies of three patients who underwent total knee replacement were carried out to document the health-related decisions associated with this procedure and subsequent rehabilitation. Semi-structured interviews were recorded, transcribed and coded for analysis. The participants were interviewed about their TKR experiences and responses fell into three main categories: (1) Adaptations & Limitations, (2) Advocacy & Attitude and (3) Fears & Burdens. The health literacy related challenges we identified focused on awareness of the TKR procedure, and expectations for the rehabilitation phase of treatment. Participants came to terms with changed bodies through new ‗rules‘ for approaching meaningful activity and new responsibilities concerning self-advocacy. These case studies highlighted the limitations of viewing health literacy from a ‗patient deficits‘ perspective and emphasized the importance of literate health systems through institutional health literacy and clear health-related communication. Keywords: Meaningful activity, TKR rehabilitation, case study design INTRODUCTION Health literacy is and the negative effects that inadequate health literacy has on patients, such as inability to interpret medical information, increased costs of health care due to higher frequency in emergency room visits, and failure to follow instructions that are given by a healthcare professional. [1-2] Possible barriers to health literacy including age, socioeconomic status, cognitive level, and chronic disease, as well as a strong correlation between older age and lower health literacy have been previously documented. [3-5] Previous studies have examined the effects of musculoskeletal conditions and/or hip fractures had on patients‘ life satisfaction scores. [6-8] These studies also investigated the impact that musculoskeletal conditions and hip fractures had on self- ratings of successful aging. Additional research has been conducted regarding strategies and models that would help to improve health literacy and overall compliance of patients. [9] Limited health literacy in conjunction with age related changes, including chronic disease and cognition changes in older adults is a significant issue that requires a patient-centered approach. [5] Prior research found that cognitive decline in older adults negatively impacts