By Leah Grebner, PhD, RHIA, CCS, FAHIMA, Midstate College
Adults age 65 and over have a greater incidence of chronic disease than the younger population. They also seek more healthcare services. The older adult population experiences greater difficulty with printed materials, forms, charts, and interpretation of calculations. Because of this, healthcare providers and family caregivers need to be aware of the health literacy needs faced by older adults.
Older adults have become accustomed to a healthcare delivery situation which has been traditionally provider-driven, so they have not developed health literacy skills that many in the younger generation have in today’s environment, which is more patient-driven. They expect that the provider will tell them everything they need to know and make necessary decisions for them. There has been a paradigm shift in healthcare that now requires the patient to take a more active role in managing their personal healthcare and making critical decisions. Patients now are expected to be more informed and equipped to ask pertinent questions regarding their care.
The need for patients to develop a higher level of health literacy in order to effectively navigate the healthcare delivery system and manage their healthcare is difficult for a population that is starting to experience a decline in sensory and cognitive abilities as part of the natural aging process. Patients in the older population experiencing impaired hearing or sight face additional obstacles when receiving verbal or written communication from healthcare providers, which further compounds the problem. Because of this, healthcare providers need to ensure that they are communicating using a route that is best comprehended by the patient, while also keeping the message in simple terms, avoiding medical jargon that may seem foreign to the patient. The healthcare provider should not assume that the patient has knowledge about medical issues being discussed and provide sufficient detail. It may be helpful for the provider to repeat critical aspects of the topic being discussed, perhaps using different methods of communication (i.e. verbal or illustrations). The healthcare provider should allow sufficient time for the older patient to process information given to them so that they can ask questions.
The older population has traditionally trusted everything from their healthcare providers and not considered themselves in a position to ask questions. Because of this, the healthcare provider must create an environment that encourages questions from the patient. The National Patient Safety Foundation and Pfizer developed a program called Ask Me 3, which encourages patients to ask at least the following three questions:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
Additionally, healthcare providers are directing patients to utilize online resources, such as patient portals, while the population of older adults are less likely to access information online. It is important to make sure that the patients understand the security involved with provision of online access to health information as older adults may feel uneasy about their information being transmitted over the Internet.
Discharge documentation following hospitalizations and physician appointments provides a significant amount of valuable information. This may include an updated medication list that reflects any changes in medications or dosages, an updated list of medical diagnoses for which the patient is being treated, and often also includes narrative details of special instructions for the patient.
Another area of concern for patients in the older population is comprehension of insurance information. It is important to know about coverage information prior to seeking healthcare services from a provider. Following services from a provider, patients receive an explanation of benefits from their insurance carrier or Medicare, outlining payments that were made to the provider. These can often be difficult to understand. Patients must understand co-pay and deductible information for their coverage.
Older adults often take a wide variety of prescription medications. Patients must acquire knowledge regarding which medications their insurance company and Medicare will cover. All patients using Medicare Part D should receive a formulary annually that lists which medications will be covered along with the co-pays for each one. Medicare Part D will not cover any medications that they think might not be safe for seniors to take.
Whether you are a family member assisting with managing healthcare coverage or an older adult navigating the system, you should become aware of resources to help understand necessary aspects of Medicare or other insurance coverage. The Centers for Medicare and Medicare and Medicaid Services (CMS) provide information for Medicare beneficiaries at www.medicare.gov. Other insurance providers generally have coverage information in a manual or on their individual websites. If you have any questions about your coverage that you can’t find online, there should be a phone number you can call listed on your explanation of benefits when you receive it.
For more information about Midstate College, please visit www.midstate.edu or call 309.692.4092. Registration is now open!