Being involved or just being informed: Communication preferences of seriously ill, older adults

Communication competence may play an important role in interactions between health care providers and patients. Because exactly what constitutes effective and appropriate communication in conversations with seriously ill, older adults is not clear, it is difficult to know haw such conversations can be improved. In this study we conducted face‐to‐face interviews with 142 randomly selected, older dialysis patients to determine if they believed it was appropriate to inform them of their medical condition, discuss treatment alternatives, and involve them in medical decision making. Results confirmed the expectation that most such individuals believe it is appropriate to be informed about their condition and options, but do not believe it is appropriate to involve them in medical decision making. Respondents who were older, less educated, and who had diminished cognitive capacity perceived involvement as particularly inappropriate. Results suggest that many seriously ill, older adults may have communication beliefs about medical decision making which create conflict between physicians’ obligation to communicate effectively and their need to communicate in a manner patients deem to be appropriate.

Key concepts:

• communication competence
• medical decision making
• patient involvement
• aging