How Senior Friendly is Your Medical Practice?

July 4, 2012

Every single day, an estimated 10,000 people in this country are turning 65. If you haven't made your practice senior-friendly, now is the time.

Every single day, an estimated 10,000 people in this country are turning 65. If you haven't made your practice senior-friendly, now is the time. The following is a partial list of things to consider:

Does your office have:

• Plenty of easy parking close to the entrance of your building - both handicapped and regular spots? Does it have ramps allowing patients to avoid steps? "Making your office safe and welcoming for elderly patients starts with the parking lot," says Richard G. Stefanacci, a geriatrician/internist in Philadelphia.

• A choice of sturdy chairs with armrests or chairs with elevated seats in the reception area?

• Handicapped-approved hallways, doorways, and rest rooms with safety rails to assist patients getting on or off the toilet? Does it have levers instead of knobs on the sink making it easier to use for those with arthritis?

• A quiet reception area or one with soothing music?

• Medical history forms and printed materials with 14-point type?

How about your staff? Are they:

• Patient and in tune with the needs of the elderly? Are they sensitive enough to recognize when a patient needs help and tactful enough to offer it without making the patient feel uncomfortable?

• Aware that hearing problems are very common among older people? "Everyone from receptionists to nurse practitioners should be told to face hearing-impaired patients while speaking to them and to enunciate clearly," says geriatrician Kenneth Brummel-Smith of Portland, Ore. "Shouting is not only rude," he adds, "it distorts the voice and lessens comprehension." It also threatens to compromise patient confidentiality if the conversation takes place within earshot of the reception area.

In addition, does your staff:

• Speak slowly and clearly when making appointments and talking with older patients -but not overly so as if they were slow witted?

• Walk at an easy-to-follow pace when escorting older patients around the office?

• Avoid addressing older patients by their first names (without permission) or using disingenuous terms such as "dear," or "sweetie"? Kristine Williams, a nurse gerontologist and associate professor at the University of Kansas School of Nursing, who has studied the effects of such language, found that healthcare workers often think that using words like "dear" or "sweetie" convey friendliness and show that they care. "But they don't realize the implications," she says "that it's also giving messages to older adults that they are incompetent."

• Help patients with medical history forms if they have difficulty seeing or completing them?

• Help patients needing assistance when getting on and off exam tables, testing equipment, and even on and off the scale?

Doctor, how about you? Do you:

• Maintain eye contact when talking or listening to patients - or focus instead on a computer screen or tablet?

• Dismiss older patients' complaints by reminding them of their age and implying (or saying) "What do you expect?"

• Make sure that patients who might be anxious, confused, or hearing impaired understand you? When explaining something for the five hundredth time, especially if you're time-pressured, it's easy to fall into the trap of "speaking-so-fast-that-patients can't- follow-you."

• Ask patients to repeat your instructions in their own words? Consultant Jacob Weisberg calls this "reverse paraphrasing" and says that it lets you know how well patients understand your instructions. "If you just tell patients and don't get any inkling of what they've understood, then the chances of compliance are greatly reduced," he says.

Molly Mettler, senior vice president of Healthwise, a nonprofit consumer health information company in Boise, Idaho, stresses the importance of monitoring the needs of older patients. "Probably the best thing a physician and office manager can do is ask older patients directly, "What can we do to make this office more accommodating for you?" she says.

To get everyone on the same page when dealing with older patients, schedule a staff meeting to discuss these issues and include the required protocols in the training of new office personnel.

Bob Levoy is the author of seven books and hundreds of articles on human resource and practice management topics. His newest book is "222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices" published by Jones & Bartlett. He can be reached at blevoy@verizon.net.