Better care of older people starts with better communication. But making sure an older patient’s care is properly coordinated comes with challenges. Many older people have more than one health condition, meaning they often receive care from more than one health service provider. Proper communication must take place between a patient and all healthcare teams involved in their treatment.
A report published in the international journal Age and Ageing called for more time to be spent during training on improving doctors’ attitudes towards older people. Even NHS boss Simon Stevens has said the care of elderly patients has, in some cases, become fragmented because of a rise in multiple conditions, which require greater coordination.
Meanwhile, a recent survey by The Commonwealth Fund of more than 15,000 older people across 11 different countries found many had suffered problems with care coordination in the past two years. In the UK, for example, 10% of respondents said they had received conflicting information from different doctors, while 20% said their regular doctor had not been informed about specialist care they had received. Planning a discharge from hospital was a problem for 38% and, overall, 24% said they had encountered some sort of problem with communication in regard to their care.
When communication fails between a patient and one or more caregivers, it can lead to serious problems, even resulting in medical negligence where a failure to relay information has resulted in detrimental care.
So, given the complexities involved in caring for older people, how do patients themselves, and their families, make sure they are able to communicate their wishes to healthcare providers, and ensure they are receiving all the information they need in return? Here are some tips for improving communication between patient and physician.
Don't Dismiss Your Symptoms
According to a research done by a firm of medical solicitors, many older people don't complain they "don’t want to make a fuss". They may see issues such as breathlessness or aches and pains as part and parcel of the ageing process. But, older people don’t have to suffer such symptoms, so it’s important for family members and friends to encourage them to see that they aren’t a burden and they have every right to go to see their healthcare provider about any problems. Older patients themselves should tell their doctor if they have any symptoms causing them concern, and not simply put them down to “old age”.
Take an Active Role
The way patients and doctors communicate has changed over the years. Whereas once, a doctor typically took the lead, it’s now much more about working together to resolve any problems and make sure your treatment is working for you. Make sure you ask questions if you don’t understand exactly what is being said or suggested, and don’t be afraid to bring up any issues, even if you haven’t specifically been asked about them. If you feel you might forget something you want to say, then make a list before you attend your appointment and refer to it when you get there. Tell your doctor about any specialist or emergency care you have received. It’s tempting to think they will already know because it will be on their computerised system, but computers are only as effective as the person entering the information.
Involve Your Family
You don’t have to make decisions about your health care on your own, and you don’t have to make them immediately. If you feel more comfortable, you could ask your doctor to involve your family in any care decisions, or ask a family member to attend your appointment with you. That way, they can prompt you if you forget something you wanted to discuss, they can take notes on your behalf and they can discuss your care with you afterwards. If there is something you wish to talk about in private, you could ask them to attend part of your appointment.
Remember Your Glasses and Hearing Aid
It’s not unusual to forget to put your hearing aid in while you’re at home, or to accidentally leave the house without your reading glasses so you can’t see any documentation your doctor is showing you. Prepare well in advance, and ask anyone attending your appointment with you to remind you to take what you need to give yourself the best chance of understanding everything that is mentioned, or shown, to you.
Follow Up and Write Down
Ask your doctor for the best telephone number and email address to contact them. That way if you, or a family member, does have questions after your appointment, you can make a follow-up call, or send a message. If you’re worried you may forget instructions about medication taking, for example, then ask for them to be written down. You can also ask for copies of your medical records, or of any correspondence between your medical teams. That way, you can be sure what is recorded is correct and take any documentation along to your next appointment.
Sometimes, even with the best efforts of a patient and their family, communication breaks down, leading to serious complications. A lack of communication really could make the difference between life and death. It may be that one medical team did not inform the other that an older patient is taking medication which shouldn’t be given with another prescription, or that a patient was not referred for treatment in a timely way. Fragmented and poorly coordinated care of this nature can lead to medical errors. A claim for medical negligence could be appropriate in these cases, to make sure you are able to fund ongoing care, or as recompense for any unnecessary suffering caused.
When talking about the best possible healthcare, it all comes down to communication, whether it is with your family or your doctor. Remember that you are not wasting anyone’s time by listing symptoms - you are actually helping the doctor make the right choice for your treatment. There are also many ways your family members can help which you would never even think of. Use this to your advantage; there is nothing more important than your health.