Practice Strategies

Communicating Effectively with Older Patients

The medical needs of elderly patients tend to be complex. Some 80% of older adults suffer from at least one chronic condition, and the average 75 year old has three chronic conditions and takes at least five prescription drugs, according to a 2004 study by the Merck Institute of Aging and Health and the Centers for Disease Control and Prevention. As health problems mount, the ability of older patients to speak with their doctors about symptoms and health concerns can deteriorate. Physicians may have problems communicating with elderly patients who are hard of hearing or experiencing cognitive difficulties, or who are reluctant to discuss certain aspects of their physical and mental decline.

With the oldest baby boomers now reaching retirement age, the percentage of Americans over age 65 is growing and is expected to reach 20% by 2030. Because seniors see their doctors more frequently on average than younger people, your practice will likely see a steady increase in the number of elderly patients seeking services. You can prepare for this demographic shift by developing strategies for interacting with older patients.

Honing your communication skills will enable you to build better relationships with elderly patients, making it easier to manage their care and avert medical errors.

It is important not to make assumptions about a patient’s abilities before getting to know him or her individually. An 85-year-old patient may be physically fit and mentally alert, while a 65 year old may be frail and struggling with dementia. In some cases, it will be necessary to speak to a family member about a patient’s care, but other elderly patients will be able to communicate and follow instructions without any assistance. Avoid speaking to family members in private about the patient’s condition unless it is clear that the patient is unable to manage his or her own care. Whenever possible, patients should be made aware of health problems and encouraged to take an active role in treatment and prevention.

If you notice a patient has difficulties hearing or processing information, make an effort to communicate as clearly as possible. This may involve speaking more slowly and clearly than normal, and maintaining eye contact with the patient while talking. Pause to make sure the patient has understood what you have said, repeating or simplifying your statements when necessary.

Physicians should also listen carefully to older patients, giving them plenty of time to ask and answer questions. Patients who have trouble recalling their health concerns or organizing their thoughts should be encouraged to write down in advance the points they wish to discuss during the visit. Consider scheduling additional time with elderly patients, especially if they are dealing with multiple illnesses. If patients sense you are in a hurry, they may fail to disclose important information out of fear that they are taking up too much of your time.

Sometimes elderly patients will be reluctant to discuss potentially uncomfortable issues such as urinary incontinence, sexual dysfunction, addiction, memory loss, or feelings of despair. Patients may even be unaware that a problem is developing. Screening tools can be used to uncover conditions patients are unwilling or unable to talk about directly.

To help older patients remember what was discussed during the visit, send them home with a list of specific instructions, such as when medications should be taken and recommendations concerning diet and exercise. The instructions should be short and simple to follow, and the handwriting or typeface should be large and easy to read. If the patient has vision problems, consider tape-recording the instructions.

Patients should be discouraged from thinking that, just because they are getting older, chronic pain and disability are inevitable. Help elderly patients plan an exercise regimen and make dietary changes that can prevent the onset or stop the progression of illnesses. Urge older patients to be as honest as possible about their symptoms, reminding them that, even when they suffer from chronic illnesses such as diabetes or arthritis, there are usually courses of treatment available that can help them live more comfortable and independent lives.

For more information about our services to the healthcare industry, contact:
Maxine Lawyer, CPA, Partner - Dallas/Fort Worth at 972.448.6905 or
Philip Fox, CPA, Partner - Houston at 713.297.6914.

The articles in this newsletter are general in nature and are not a substitute for accounting, legal, or other professional services. We assume no liability for the reader's reliance on this information. Before implementing any of the ideas contained in this publication, consult a professional advisor to determine whether they apply to your unique circumstances.
© 2007