1. Villaire, Michael MSLM
  2. Mayer, Gloria RN, EdD, FAAN


Purpose/Objectives: Chronic disease affects 90 million American adults and disproportionately affects the elderly. Health literacy, or the ability to understand and apply information to care for oneself, is a challenge for the approximately 1 in 2 American adults who cannot read above a fifth-grade level. This article defines the problem of health literacy and provides useful information for case managers to better understand the scope of the problem and strategies for working with patients to ensure good communication.


Primary practice setting(s): All settings.


Findings/Conclusions: Raising awareness of the scope of low literacy among patients is critical for any practice. Implementing basic practices to ensure effective communication will increase the likelihood of patient compliance and successful outcomes.


Implications for case management practice


* Keep key messages to patients to a minimum.


* Use the teach-back method with patients to ensure that they understand their care regimen and warning signs.


* Never ask, "Do you understand?" Ask patients to explain processes.


* Have your written patient education materials reviewed by a literacy expert to determine grade reading level. Materials should not be above a fifth-grade level, and should be culturally appropriate.