Elderly Patients Can Help You Help Them

The biggest reason that physicians give "suboptimal care" to elderly patients is a "lack of time and resources," says David Reuben, MD. One way to improve the time crunch? Learn to delegate to the patients themselves, he suggested.

For starters, send patients a "pre-visit questionnaire" in the mail. "Our questionnaire is 20-pages long. But it's easy to read and has big type," said Reuben, professor of geriatrics, David Geffen School of Medicine at UCLA. The questionnaire return rate in Reuben's practice is "about 80%." "The questionnaire reduces history-taking in the office from a half hour to 7-8 minutes," he said.

Next, send patients a "follow-up questionnaire" after the visit. It can be general or specific to conditions such as dementia or incontinence. "This tool helps the physician to monitor patient adherence," said Reuben.

Also, request that elderly patients bring along a "list of problems" to their office visit. "A list helps keep the interview moving along. And if a patient brings up something that is not on list, it's probably not important," Reuben said.

Finally, ask patients to keep a symptom diary. "If a patient has a vague, hard-to-understand problem, I ask them to keep a log that describes and records its incidence," Reuben says. He distributes free, calendar-like diaries to his patients to ensure the request is undertaken. For some reason, the act of diary-keeping has a positive effect on health. "The problem often goes away - a diary is one of my best therapeutic interventions," Reuben claims.