Treating elderly patients can be a challenge. They often require complex, time-consuming care, and it is the rare doctor that is trained in geriatrics. Still, even taking these issues into consideration it is hard to deny that doctors are failing their older patients. A 2014 Ethics Survey showed that a quarter of doctors would devote scarce or costly resources to younger patients over older patients, while a 2004 study found that elderly patients were less likely to get life-extending care, such as surgery and dialysis, compared to younger patients, even when excluding patients who openly denied that care.
As the percentage of aging patients goes up healthcare providers will need to take active steps to ensure they are able to care for them. Here are three ways for hospitals to better serve aging populations:
Avoid "elderspeak": It is not uncommon to hear people, even doctors and nurses, speak to the elderly using a form of baby talk that involves talking loudly, slowly or calling patients pet names such as "sweetie" or "honey." While this behavior may seem kindly, it feels highly condescending for the person on the receiving end. Assume baby talk is inappropriate for anyone above the age of four. Getting rid of the habit of "talking down" to patients early on will help you avoid the behavior later on. Most people, from children to the elderly, prefer being spoken to as equals. In aging populations elderspeak can even result in poorer health outcomes, according to Medscape.
Don't ignore complaints: There are many health issues that come along with getting older, but don't fall into the trap of assuming that all of a patient's afflictions are simply a result of their aging minds or bodies. Robert Stall, M.D., a geriatrician in Amherst, New York told FierceHealthCare, "Old age is not an illness. Older people get sick from disease, not old age." Never assume that complaints of a loss of bladder control, decreased mobility and memory impairment can be brushed off. Not only does that suggest to the patient that you don't truly care about their concerns, it makes it more likely that you will miss warnings signs that could help prevent or detect serious illnesses.
Recognize red flags: In elderly patients a lack of complaints altogether can be a warning. Many doctors expect a degree of stoicism from their older patients, who tend to complain less, brush off signs of illness, and tell their doctors that "everything is fine."
John Henning Schumann, M.D described such a relationship on NPR, where his long-term elderly male patient was diagnosed with Alzheimer's by another doctor. Schumann failed to recognize the red flags in his meetings with the patient: His tendency to shrug and assure the doctor that he felt good, and the notes that he would bring from his wife which listed his medications and various health concerns.
"His visits were a model of efficiency," Schumann wrote. "And that was a problem. A doctor has a sixth sense, or should, that when things are going too smoothly there's probably more to the story."
There are always going to be patients, especially in aging populations, who prefer to roll with the punches and aren't forthcoming about medical complaints. Good clinicians should, however, be able to deduce when they might be missing important information that could change health outcomes.
Partnering with Patient Approved can help healthcare leaders come to better understand aging populations and their needs. Doctors can access real-time feedback and respond to concerns that patients list on the website.