As the American Medical Association (AMA) reported, “within the next two decades, one-in-five Americans will be older than 65.” This “silver tsunami” will have major implications for how healthcare policymakers and providers alike adapt to meet the needs of America’s aging population.
The effects of this “graying” of the patient population will be especially pronounced for primary care providers. Research from Accenture found that 85 percent of patients in the Silent Generation (born between 1928 and 1945) and 84 percent of Baby Boomers (born between 1946 and 1964) have a primary care physician.
To better serve this demographic, the healthcare industry must rethink how it cares for elderly patients. As Liz Seegert wrote for NBC News, “An analysis of National Health and Retirement study data found that 1 in 5 adults over 50 experiences age-related discrimination in heathcare settings; 1 in 17 said they experience it frequently. This bias is associated with new or worsening disability, poorer mental and physical health, and use of fewer preventive health services.”
Therefore, it is vital that we explore ways that primary care physicians — and healthcare providers generally — can better understand and meet the needs and preferences of their aging patients.
Embrace and Assist With Technology
There remains a persistent belief that older patients can not or will not use technology in their healthcare. To some extent, evidence supports this belief. Data shows that 93 percent of Silent Generation patients and 91 percent of Baby Boomers prefer “physical, in-person experiences with doctors and other medical professionals.” However, this is a preference and allows for technology if implemented properly.
The COVID-19 pandemic has proven that senior patients are willing to adopt health technology. In fact, 97 percent of elderly patients reported a positive telehealth experience. Data from Strata Decision Technology supports and contextualizes this finding. While patients ages 60–69 reported nearly 24 percent telehealth utilization, this is only slightly lower than the highest utilizers, ages 30–39, at approximately 28 percent. Therefore, Medicare-aged patients are certainly willing, if sometimes reluctant, to incorporate technology as a part of their healthcare.
Telehealth and other healthcare technology can help to increase patient touchpoints, access, and engagement and overcome barriers to care. “Historically, we had to deal with older folks who may not be able to drive and older folks who would have difficulty finding a parking space. If the weather was bad, some older folks did not want to go to a doctor appointment. Driving for older folks is problematic in terms of compliance. But now with telehealth, that situation has been resolved,” Jeffrey Gelblum, MD, noted in an article from HealthLeaders Media.
To increase technology adoption among older patients, physicians can leverage their strong doctor-patient relationship since older patients are more likely to trust their doctors. Physicians can promote adoption by using the following strategies:
- Fortify your cybersecurity and address privacy concerns. Older patients are often more skeptical of data privacy. A survey by SAS found that 78 percent of respondents ages 55 expressed concerns about their data privacy. Make sure your technology platform’s security is up-to-date so that you can confidently calm any patient reservations.
- Offer patient education. Any new technology has a learning curve that can deter patients from trying it. To offset this, work to educate patients on usage. For example, find or put together a how-to guide for virtual visits. See whether your electronic health record (EHR) vendor offers tutorial videos. Search YouTube for demos about how to use your patient portal.
- Tie technology to patient needs. Remember that technology is a tool, a means to an end. Relate the value of technology back to what patients want. Does a patient want convenient, on-demand access to their health information? Demonstrate how a patient portal can help them access it. Are they interested in at-home healthcare? Explain how they can use telehealth to receive care from home.
Lean Into Your Role as an Educator and Advocate
In addition to their role as a clinician, physicians also serve as educators and advocates for their patients. As Sally Goza, MD, notes: “Our patients today have greater access to information than ever before, but we still need to ensure that they’re properly equipped to understand their care plan.” This is where patient education comes into play. Patients often have many questions about not only their health, but about healthcare more generally. For instance, the primary care physician may be the source for older patients to go to for questions related to Medicare or Medicare Advantage. You can assist patients by offering a variety of informational resources: explanatory videos, pamphlets and brochures, or a professional Medicare advisor.
Similarly, you can educate patients on ways to find high-quality, lower-cost care. any tools, such as Care Compare from the Centers for Medicare and Medicaid Services (CMS), can empower and equip patients with important information. Patient engagement can reduce the cost of care, as well, benefitting providers participating in value- or risk-based contracts.
Treat the Social Determinants of Health
Research shows that social determinants of health — income, education, access to transportation, and more — may account for up to 80 percent of health outcomes. However, many providers do not screen for or address social needs. While these screenings are important for all patients, elderly patients are more likely to experience problems related to certain social determinants of health. For instance, check to make sure your patient has a stable and secure internet connection so that they can use telehealth. Because many older patients face transportation issues, ensure they have a way to get to in-person appointments and the grocery store. Older adults also face an increased risk for loneliness and social isolation. Chronic loneliness is equivalent to smoking 15 cigarettes a day, and lonely patients are 50 percent more likely to die prematurely. The National Academies of Sciences, Engineering, and Medicine (NASEM) advise that “clinicians periodically assess patients who may be at risk and connect them to community resources for help.” The Centers for Disease Control and Prevention (CDC) recommend the following resources: Area Agencies on Aging, Eldercare Locator, National Council on Aging, and AARP.
Health literacy is another important social determinant. Providers can bolster their patients’ health literacy by using simple language, offering multimedia materials, and asking patients to repeat back their treatment plans using their own words to check for comprehension. Improved health literacy can save billions while improving health outcomes, especially among Medicare beneficiaries.
Communication is a key element of health literacy and screening for social determinants of health. “Good communication is an important part of the healing process,” according to the National Institute on Aging. “Effective doctor-patient communication has research-proven benefits: Patients are more likely to adhere to treatment and have better outcomes, they express greater satisfaction with their treatment.”
Understanding patient preferences is a critical part of meeting patients where they are. However, there is no one-size-fits-all approach; every patient is unique. By embracing and assisting your patients with technology, acting as an educator and advocate, and addressing the social determinants of health, primary care physicians can better engage older patients.