expanding to meet the growing need. china is still at an earlier stage in economic development and will be challenged to build these services and train staff. india india's cultural view of elderly care is similar to that of nepal. parents are typically cared for by their children into old age, most commonly by their sons. in these countries, elderly citizens, especially men, are viewed in very high regard. traditional values demand honor and respect for older, wiser people. using data on health and living conditions from india's 60th national sample survey, a study found that almost a fourth of the elderly reported poor health. reports of poor health were clustered among the poor, single, lower-educated, and economically inactive groups. under its eleventh five-year plan, the indian government has made many strides similar to that of nepal. article 41 of the indian constitution states that elderly citizens will be guaranteed social security support for health care and welfare. a section of the 1973 criminal procedure code, alluding to its traditional background, mandates that children support their parents if they no longer can themselves. nepal due to health and economic benefits, the life expectancy in nepal jumped from 27 years in 1951 to 65 in 2008. most elderly nepali citizens, roughly 85%, live in rural areas. because of this, there is a significant lack of government sponsored programs or homes for the elderly. traditionally, parents live with their children, and today, it is estimated that 90% of the elderly do live in the homes of their family. this number is changing as more children leave home for work or school, leading to loneliness and mental problems in nepali elderly. the ninth five-year plan included policies in an attempt to care for the elderly left without children as caretakers. a senior health facilities fund has been established in each district. the senior citizens health facilities program implementation guideline, 2061bs provides medical facilities to the elderly, and free medicines as well as health care to people who are poverty stricken in all districts. in its yearly budget, the government has planned to fund free health care to all heart and kidney patients older than 75. unfortunately, many of these plans are overly ambitious, which has been recognized by the nepali government. nepal is a developing nation and may not be able to fund all of these programs after the development of an old age allowance (oaa). oaa provides a monthly stipend to all citizens over 70 years old and widows over 60 years old. there are a handful of private day care facilities for elderly, but they are limited to the capital city. these day care services are very expensive and beyond the reach of general public. thailand thailand has observed global patterns of an enlarging elderly class: as fertility control is encouraged and medical advances are being made, the birth rate has diminished and people live longer. the thai government is noticing and concerned about this trend but tends to let families care for their elderly members rather than create extraneous policies for them. as of 2011, there are only 25 state-sponsored homes for the elderly, with no more than a few thousand members of each home. such programs are largely run by volunteers and the services tend to be limited, considering there is not always a guarantee that care will be available. private care is tough to follow, often based on assumptions. because children are less likely to care for their parents, private caretakers are in demand. volunteer ngos are available but in very limited quantities. while there are certainly programs available for use by the elderly in thailand, questions of equity have risen since their introduction. the rich elderly in thailand are much more likely to have access to care resources, while the poor elderly are more likely to actually use their acquired health care, as observed in a study by bhumisuk khananurak. however, over 96% of the nation has health insurance with varying degrees of care available. medical (skilled care) versus non-medical (social care) a distinction is generally made between medical and non-medical care, the latter not being provided by medical professionals and much less likely to be covered by insurance or public funds. in the us, 67% of the one million or so residents in assisted living facilities pay for care out of their own funds. the rest get help from family and friends and from state agencies. medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home. assisted living facilities usually do not meet medicare's requirements. however, medicare pays for some skilled care if the elderly person meets the requirements for the medicare home health benefit. thirty-two u.s. states pay for care in assisted living facilities through their medicaid waiver programs. similarly, in the united kingdom the national health service provides medical care for the elderly, as for all, free at the point of use, but social care is paid for by the state only in scotland. england, wales and northern ireland have failed to introduce any legislation on the matter and so social care is not funded by public authorities unless a person has exhausted their private resources, such as by selling the home. money provided for supporting elderly people in the uk has fallen by 20% per person during the ten years from 2005 to 2015 and in real terms, the fall is even greater. l experts claim that vulnerable uk people do not get what they need. however, elderly care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities, rather than the resident, may be providing the cost of care. if residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern. the adult protective services agency, a component of the human service agency in most states, is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers. shared-decision making during primary care there is currently limited evidence to form a robust conclusion that involving older patients with multiple health conditions in decision-making during primary care consultations has benefits. examples of patient involvement in decision-making about their health care include patient workshops and coaching, individual patient coaching. further research in this developing area is needed. promoting independence older adults are scared of losing their independence more than they fear death. promoting independence in self-care can provide older adults with the capability to maintain independence longer and can leave them with a sense of achievement when they complete a task unaided. older adults that require assistance with activities of daily living are at a greater risk of losing their independence with self-care tasks as dependent personal behaviours are often met with reinforcement from caregivers. it is important for caregivers to ensure that measures are put into place to preserve and promote function rather than contribute to a decline in status of an older adult that has physical limitations. caregivers need to be conscious of actions and behaviors that cause older adults to become dependent on them and need to allow older patients to maintain as much independence as possible. providing information to the older patient on why it is important to perform self-care may allow them to see the benefit in performing self-care independently. if the older adult is able to complete self-care activities on their own, or even if they need supervision, encourage them in their efforts as maintaining independence can provide them with a sense of accomplishment and the ability to maintain independence longer. a study done by langer and rodin in 1976, investigated what the impacts could be if nursing home residents are given more responsibility in different daily activities, and more choices, compared if those responsibilities given to the nursing home staff. residents in the nursing home were split into two different groups. one group of elderly residents was given more responsibility in their choices, and their day-to-day activities than the other group. this involved differences such as having the hospital administrator talked separately to the two groups. the group that was more responsibility induced was given a talk emphasizing their responsibility for themselves, while the talk given to the second group emphasized the responsibility of the nursing staff in taking care of the elderly residents. another difference between the two groups is that both groups were given a plant. the group that was more responsibility induced was told they there were responsible for watering the plant each day while, the second group was told that the nursing staff was responsible for watering the plant. results from this study indicated that the group that was more responsibility induced became more active, reported being happier, and increased alertness and they showed increased behavioral involvement in activities such as socializing, participation, and attendance in the nursing home activities such the nursing home's movie nights. they also showed higher health and mood which also declined more slowly than the previous group over time. it is also noted that these long-term benefits were most likely obtained because the treatment was not directed toward one single behavior or stimulus condition. elderly-friendly interior design plays a vital role in promoting independence among the elderly. the integration of internet of things (iot) in smart homes provides a remote monitoring system to keep track of the daily activities of the elderly. thus adults can live on their own confidently knowing that a feedback alarm will be sent to their caregivers immediately in case of an emergency. this not only allows the aging population to maintain their independence and confidenc, but also brings peace of mind to their friends and family. improving physical mobility