People trust old doctors more

Patient communication: the elderly patient in the practice

The doctor and his practice team must expect more and more seniors to visit the practice in the future. Those who adjust accordingly can also benefit from it.

As a result of demographic development, people are getting older and the proportion of older patients in medical practices continues to increase. The demands on their own health have increased among the elderly, especially since many are still vigorous and active. Seniors, however, often have different expectations and needs than younger patients and want an appropriately adapted environment. When the doctor and his practice team adjust to the group of seniors, the older patient will appreciate this. This includes not only the barrier-free equipment of the practice, but above all the discussion situation and the sensitive handling of this demanding but loyal group of patients.

For example, older people often hear less than younger patients. Older people who speak loudly on the phone, at reception or during treatment signal this. Flexibility and the speed of reaction often decrease, as does the ability to absorb. The interlocutor has to adjust to this. During the therapy discussion, the doctor should therefore slow down his or her pace of speech and repeat important statements.

Adjust the pace

With increasing age, patients often do not immediately understand what is being recommended to them. In addition, some are also suspicious when the doctor is much younger. They sometimes assume that a younger doctor has a lack of experience, but do not talk about it.

At the same time, unlike in the past, seniors are now increasingly using the Internet to find out about their illness before and after visiting the doctor. The web is suitable for providing advance information, but it can also cause confusion because the user does not understand everything and misinterprets many things. The doctor must be prepared for the previously informed patient to report on his research on the Internet in the practice. The patient often wants confirmation of his research, but the doctor must patiently and diplomatically correct incorrect statements. This can extend the treatment time.

Regular patients are open to small talk and welcome it when asked about their well-being at the beginning. Some of the older patients like to come to the practice and contact us even if there is nothing special. Sometimes the physician's empathy is required to end "excessive" conversations.

People over 50 already prefer drugs they know. Older people gradually become skeptical about new drugs and ask for the known preparations. This is especially true for multimorbid patients who often have to take many different preparations. If the doctor recommends a new product, he should explain clearly why a change is necessary. In complicated cases, he should recommend that the patient bring a close relative with him on the next visit in order to avoid misunderstandings when the doctor advises them.

The limitations in sensory functions and motor skills that come with aging are happily suppressed by many seniors. Some act like they're 20 years younger. You are looking for a sporting challenge and want to achieve your fitness from earlier. It is right to encourage these patients. On the other hand, the doctor should also point out limits to this ambitious group of patients. Hip prosthesis patients who enjoy playing tennis regularly need to know what they are risking. Those who encourage a patient influence their athletic behavior and thus assume part of the responsibility. Doctors who are athletic themselves sometimes tend to be somewhat generous when it comes to exercise.

Because of their age, patients have had their own experience of illness. They are sensitized and usually take medical advice very seriously. They try less than younger patients to help themselves through self-medication. The older a person gets, the more careful he is with his body. Older people who are fit are happy to be recognized by the doctor. Relationships and trust in "your doctor" are particularly important. The patient wants to have the feeling that "his doctor" is always doing a little more for him, taking his time and explaining it with particular care.

Older patients usually do not want to be “old”. Your image of yourself has "rejuvenated" in recent years. Nevertheless, they show differences to younger patients (box): They want more attention and orientation, prefer the doctor's practice they are familiar with and remain loyal to it when they are satisfied. Younger patients, on the other hand, are more willing to switch. Seniors also make recommendations to their own families, they make word of mouth: A satisfied patient tells about 14 other people. Word of a high satisfaction rate thus gets around and also brings new and younger patients to the practice. Seniors are good advertising media and are very grateful if they are treated successfully, even if they do not expressly state it.

Performance evaluation

The performance assessment of a doctor's practice by patients can generally be divided into three core areas, which should also be considered from the perspective of the elderly:

“Must-factors” definitely trigger dissatisfaction if the patient's expectations are not met, but do not yet generate satisfaction if the expectations are met. Adhering to appointments with a tolerance limit of around 45 minutes is a must in practice, for example. Shortening the waiting time would prevent dissatisfaction, but it would not result in any significant satisfaction. Accessibility for frail elderly patients is also one of them.

“Plus factors” are services that the patient does not expect because they are not offered by other doctors either. Patients can be positively surprised with special services, such as parking spaces for patients. Addressing older patients in counseling is seen as an advantage. The same applies to special appointments (daily acute consultation hours). If these services are not offered, there will be no express dissatisfaction. Patients are not prepared to calculate plus factors against must factors.

“Should factors”: They lie between the must and plus factors. Depending on whether they are perceived as strong, neutral or weak, they can generate satisfaction, indifference (gray area) or dissatisfaction. Indifference is often wrongly interpreted by the doctor as satisfaction. Examples of target factors are the feel-good atmosphere in the waiting room and the attentiveness and friendliness of the staff. Both the characteristics of these factors and their perception by the patient are different.

In general, there is no such thing as the elderly patient. There are big differences in the over 60 age group, everyone reacts differently. The practice staff must not under any circumstances categorize senior citizens negatively. Critical statements by older patients, on the other hand, are to be seen as suggestions and opportunities for improvement. Because they give the practice the opportunity to analyze and correct errors and thereby bind patients to the practice. Rolf Leicher

Common features of elderly patients

  • They stick to habits, for example they prefer known drugs.
  • Your comprehension has slowed down at times, so important things have to be repeated.
  • You become more impatient and don't want to wait long for an appointment.
  • You are faithful to the practice and are not ready to change quickly.
  • They are often awkward to report on their ailments.
  • They tend to be more careful about their health.