Improving Communications With Patients and Families in Geriatric Care. The How, When, and What

Abstract

There has been little published literature examining the unique communication challenges older adults pose for health care providers. Using an explanatory mixed-methods design, this study explored patients’ and their family/caregivers’ experiences communicating with health care providers on a Canadian tertiary care, inpatient Geriatric unit between March and September 2018. In part 1, the modified patient–health care provider communication scale was used and responses scored using a 5-point scale. In part 2, one-on-one telephone interviews were conducted and responses transcribed, coded, and thematically analyzed. Thirteen patients and 7 family/caregivers completed part 1. Both groups scored items pertaining to adequacy of information sharing and involvement in decision-making in the lowest 25th percentile. Two patients and 4 family/caregivers participated in telephone interviews in part 2. Interview transcript analysis resulted in key themes that fit into the “How, When, and What” framework outlining the aspects of communication most important to the participants. Patients and family/caregivers identified strategic use of written information and predischarge family meetings as potentially valuable tools to improve communication and shared decision-making.

A Qualitative Analysis of Older Adults’ Views of Healthcare Provider Attributes and Communication Skills

“…This study illustrates a framework of “How” the healthcare team communicated, “When” they communicated, and “What” they communicated. ( 8 ) Our study demonstrates “How” HCPs communicated was important for OAs with responses that included terms such as active listener, attentive, thorough, and empathetic” descriptive of a “good provider”. They provided responses such as disengaged, hasty, neglectful, and lack of eye contact for “bad providers.”…”

“…Like other studies, the themes from our study support improving patient-centered care and communication. ( 8 , 9 ) Huang and colleagues study evaluated how geriatric patients and their caregivers perceive HCP’s communication skills in an inpatient setting. This study illustrates a framework of “How” the healthcare team communicated, “When” they communicated, and “What” they communicated.…”

Reducing delayed transfer of care in older people: A qualitative study of barriers and facilitators to shorter hospital stays

“…Potential solutions include providing older people and family members with a two‐way communication checklist of questions about discharge, which could help initiate conversations and help better prepare them 40 . More strategic use of written information and predischarge meetings focused on discharge assessments and what to expect after discharge have also been shown to improve shared decision‐making in geriatric inpatient care 41 …”

Age discrimination perceived by hospitalized older adult patients in Iran: A qualitative study

“…In a previous study, Huang et al also reported inappropriate communication styles between the healthcare team and older adult patients. 37 Another study stated that older adult patients expect the healthcare team should primarily act based on the principles of good communication, take the concerns of older people into account, and share information and decisions with them. 38 …”