The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients

Abstract

There is growing evidence that the outcomes of health care for seniors are dependent not only upon patients’ physical health status and the administration of care for their biomedical needs, but also upon care for patients’ psychosocial needs and attention to their social, economic, cultural, and psychological vulnerabilities. Even when older patients have appropriate access to medical services, they also need effective and empathic communication as an essential part of their treatment. Older patients who are socially isolated, emotionally vulnerable, and economically disadvantaged are particularly in need of the social, emotional, and practical support that sensitive provider-patient communication can provide. In this review paper, we examine the complexities of communication between physicians and their older patients, and consider some of the particular challenges that manifest in providers’ interactions with their older patients, particularly those who are socially isolated, suffering from depression, or of minority status or low income. This review offers guidelines for improved physician-older patient communication in medical practice, and examines interventions to coordinate care for older patients on multiple dimensions of a biopsychosocial model of health care.

Keywords:

• physician-patient communication
• adherence
• health outcomes
• vulnerable populations

Acknowledgements

This work was supported by a Robert Wood Johnson Foundation Investigator Award in Health Policy Research, by a grant from the National Institute on Aging 5R03AG27552-02, and by the Committee on Research of the U.C.Riverside Academic Senate. The views expressed in this paper are those of the authors alone and do not imply endorsement by the funding sources.