Heath and Aging

Talking With Your Older Patient: A Clinician's Handbook

Considering Healthcare Perceptions

At a Glance

  • Avoid making assumptions about your older patients; they are diverse and will have different views of aging.
  • Remember: Most health problems are caused by disease, not normal aging.
  • Expect baby boomers to actively participate in their health care.
  • Ask about the patient's priorities for care.

Older woman and her doctorDuring the past century, the nature of old age has changed dramatically. In the early 1900s, average life expectancy at birth was about 49 years—today, it is nearly 80 years. With longevity, however, comes the sobering news that older people may live for years with one or more chronic, potentially disabling conditions. This means they will have an ongoing need for medical services.

No single characteristic describes an older patient. Each person has a different view of what it means to be old.

"This is one of the best times of my life..."

older womanMrs. Hill, age 85, lives in a nursing home. Her adult children think it must be depressing, but they don’t know what else to do. One day, Mrs. Hill's doctor asks her about life in the facility. She tells him that this is one of the best times of her life—people prepare and deliver her meals, she has a comfortable room with a view of the gardens, and the place is very peaceful. Mrs. Hill is quite happy. The best way to learn what is and is not acceptable is to communicate directly with patients and caregivers. For Mrs. Hill, a life her children find unacceptable is, in fact, just fine with her.

Views of Aging

Ageism can work both ways. Doctors can make assumptions about their older patients. Older people may unwittingly assume the stereotypes of old age. Those with treatable symptoms may dismiss their problems as an inevitable part of aging and not get medical care. As a result, they may suffer needless discomfort and disability. Some may not even seek treatment for serious conditions.

The process of aging may be troubling for older adults. It can be especially hard for people who were generally healthy and could bounce back quickly from an illness. Experts observe that baby boomers bring different expectations, experiences, and preferences to aging than did previous generations. For instance, some boomers will want to participate actively in their health care and work collaboratively with clinicians to determine what treatments might best work for them. They frequently go online to search for health information.

Values about Health

Consider starting an appointment with the following question: "What are your goals for your care?" Although clinicians typically focus on diagnosing and treating disease, older people generally care most about maintaining the quality of their lives. They are not necessarily preoccupied with death. In fact, many older people are relatively accepting of the prospect of death and want to make the most of their remaining years. Younger family members, who might have to make life-and-death decisions when an older person is incapacitated, may be unaware of the patient's views and preferences.

NIA has free health and aging materials in English and Spanish. Some are easy-to-read publications. You can download or order copies online at www.nia.nih.gov/health.

 

Publication Date: April 2016
Page Last Updated: April 26, 2017