Often, caring for an older adult requires a team that includes his/her friends and family members.
Welcome to the inaugural post of my U.S.News geriatric medicine series. My name is Ronan Factora, and I am a geriatrician at the Cleveland Clinic. By virtue of my job, I see patients over the age of 65. The average age of patients I see in my clinic is 85, and the oldest person I have ever had the honor of caring for was 105. Aside from the clinic, I also see patients in the hospital setting, as well as in the .
Many of my patients have health problems that interfere with their ability to completely understand what happens during their medical visit. Some of these individuals have significant difficulty hearing, which is associated with normal aging but may often be exacerbated by lifelong exposure to loud noises (due to, for example, working in construction or manufacturing for many years, despite wearing hearing aids). In addition to hearing difficulties, my patients may experience vision problems, such as diabetic retinopathy, macular degeneration, and glaucoma. These conditions may prevent my patients from being able to read the instructions I print for them in the after-visit summary at the conclusion of their appointment. Other individuals have cognitive impairment or dementia that interferes with their ability to understand or remember the instructions I provide during their visit.
These are just a few reasons it’s important for individuals who are older to regularly (and for others only occasionally) bring someone with them to their visits. Other advantages to having family members or friends accompany them include helping the patient make sure all concerns are addressed by the physician. They can also help confirm the medication list the physician has is correct. This list should include over-the-counter medications, vitamins, minerals and health/herbal supplements. Many individuals do not consider these to be medications, but sometimes, particularly in the cases of , they interact with prescribed medications.
Often, patients are unaware of what the are supposed to do. It is worthwhile for the patient and the individuals accompanying them to the visit to review the purpose of these medications with the medical provider. This is also the opportunity to review whether or not the medications are doing what they are intended to do in the first place, and make sure the patient’s medical problems are being addressed appropriately.
Aside from the concerns that the patient brings to the visit, the physician also has to review the medical problems that are being managed to see if there are any new developments, review prior test results and determine if any additional testing is needed. At the end of a visit, a final plan that should address the concerns of the patient and the medical provider is put in place. The accompanying person can help make sure the patient understands the instructions of what to do next (written, if possible, for review after the visit). This is the time for final questions about the plan of care, and having someone accompanying in the visit can help make the sure instruction is understood and what to do if problems arise in the future. Importantly, that person can make sure the information is not lost.
Often, caring for an older adult requires a team that includes his/her friends and family members. Through my experience seeing older patients, I realize to an appointment not only helps ensure the best outcome from the visit, it also delivers an added benefit of emotional support for the patient. I welcome and encourage a supportive friend or family member to accompany patients when they see me.