Ten Tips for Doctors Who Care for Older People

Residents of Presbyterian Homes’ Westminster Place recently offered advice to visiting medical
students from Northwestern University’s Feinberg School of Medicine about “What Doctors
Should Know About Older Patients.” Among their tips:
Prior to the encounter,
• Realize that aging can be accompanied by anxiety or depression; frustration with
deterioration in health; fear of uncharted territory; anger about loss of independence;
confusion, stubbornness, or loneliness. Remember also that old age can be a time of
loss—of spouses, friends, hearing, vision, agility, and home. Therefore your older
patients may have, in addition to their physical problems, psychological issues caused
by coping with loss.
• Establish your knowledge credentials, but also your credibility. Your credibility as a
professional is evaluated from your appearance, your attitude, and your demeanor.
• Look at your older patient as a whole person, not just as a stereotypical “old person” or
as a collection of diagnoses.
In your examination,
• Remember that your older patients who live in the community may be isolated. Always
keep in mind the social aspects of any health condition you are evaluating.
• Learn to listen as your older patients recount their problems. Try to get a full picture of
the problems, which can often be achieved by going over a list of questions your older
patient has made before the appointment.
• Remember that you are part of a health care team. Older patients will often share vital
information with other health professionals, so you will only really know your patient if
you practice as a team.
After the encounter,
• Be willing to explain your diagnosis and plan of treatment to the older patient. Make sure
the patient understands your explanation, particularly about drugs you are prescribing.
Be patient: repeat or write out instructions as necessary.
• Don’t treat your older patient like a child. In particular, don’t assume that their problems
are too complex for patients to understand or that they would not want to know about
them.
• Always be honest with your older patient. They can handle more than you think they can.
Finally, advised one resident, doctors should observe their parents, grandparents, and other
older people of their acquaintance to notice the attitudes and behaviors that lead to successful
aging.