Elderly patients need special connection
Show patience, kindness, but dont be condescending
By Sandra Lee Breisch
Some elderly patients are a little hard of hearing, slow on comprehending clinical jargon and/or create confrontational visits by challenging your every word and treatment plan. Caring for them can be a difficult undertakingeven if theyre not frail or dont have Alzheimers disease.
"Certainly, theres a subset of elderly patients who need special attention," says Peter Pompei, MD, director of the fellowship program in geriatric medicine, Stanford University Medical Center, Stanford, Calif. "But theres a slippery slope of being too condescending by treating every aging patient like a child. Its not really fair to paint every elderly patient with the same brush."
To be sure youre not on a "slippery slope" with your elderly patients, Dr. Pompei suggests patience, kindness and offers helpful hints:
Always, give your patient good care by "treating them like theyre your parents or grandparents," suggests Elton Strauss, MD, chief of orthopaedic trauma and reconstructive surgery, department of orthopaedic surgery, Mount Sinai Medical Center, New York.
And be "more patient" with a grumpy patient, says Dr. Strauss. "Ask them, why are you grumpy? or, what upset you? If they feel that youre interested enough and caring to ask whats wrong with themnot just why their knee is swollenitll calm them down. And theyll communicate with you."
Simplify medication instructions. "Lets say the patient is taking drug A and you want them to take drug B," explains Dr. Strauss. "Ill write them a note that says, Do not take drug A anymore. Instead you are to take drug B. And I write down, take one tablet in the middle of breakfast so that youre eating food. I also ask them to repeat what I just wrote down so I know they understand."
To help patients understand a musculoskeletal problem such as an arthritic hip, Dr. Strauss shows them a picture of a normal hip and writes normal on it. "Then, I show them a photograph of an abnormal hip and put their name on it, so they understand what their hip looks like," he says. "Ill give them those papers to take home."
Remember, making that special connection with the aging patient is critical to achieving good outcomes, says Dr. Pompei. "And most physicians can do it, if they try."
Communicate welcomes suggestions about future topics for the column on patient-physician communications. Send your suggestions to the Bulletin at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018.