Ready Or Not Role Play: Bridging the Communication Gap Between Older Patients and Healthcare Professionals

With over 20 percent of the American population over the age of 60, it is essential for healthcare professionals to have the ability to effectively communicate with the older patients. By 2050, people over the age of 60 are expected to make up between 25 to 29 percent of the United States population. All too frequently, routine doctor appointments, or serious medical exams, leave elderly patients anxious and confused.

Ready or Not Role Play

It is not uncommon for elderly patients to feel rushed during a visit with their physician, especially when they are being informed of new medications or conditions they might not be familiar with. In a National Poll on Healthy Aging, which surveys Americans over age 50, 25 percent said their health provider ordered tests or prescribed drugs they didn’t feel they really needed. However, about half followed through with the test or filled the prescription anyway.

On the reverse side, about 10 percent of those polled said their health provider told them that a test or medication they’d requested wasn’t needed. Most of the older patients in the ratio said the provider explained why, but 40 percent didn’t completely understand the explanation. When an older patient doesn’t completely understand the reasoning behind certain treatments or medications, they are more likely to not follow through with treatment or medical recommendations. 

“The goal of Ready or Not Role Play is to try to improve communication and comprehension for seniors when they go to see a physician because we know they are seeing specialists for many different things,” said Tina Elmlinger, RN, Serving Our Seniors healthcare advocate trainer. “And to ensure they are preparing themselves to make the most out of the short visit they are having with doctors’ appointments.”

Ready or Not Role Play is a program offered by Serving Our Seniors Sandusky that works to bridge the communication gap between older patients and healthcare professionals. The first session was held January 21, 2019. Six seniors volunteered to participate in the scenario along with one medical resident from Firelands Regional Medical Center. 

“We create a scenario of bad communication between a patient and their physician, and then another scenario demonstrating good communication,” said Tina. “We start with prioritizing questions. Making the hardest question the first question, and then questions to ask the doctor while you have their attention.”

“A lot of people leave and ask the nurse questions they should have asked the doctor, or they get home and realize they didn’t ask the doctor questions. We’re trying to polish that up the best we can for seniors.”

“After the program, the seniors realized they focused on one question and didn’t take the time to comprehend anything else that the doctor had told them,” said Tina. 

For example, a scenario could be an older patient visiting their physician for a urinary tract infection. The patient would focus so heavily on the UTI, they would not remember what the doctor had said about the treatment plan. 

“Of course it’s a different setting and not in a doctor’s office, but the seniors realized if they are suspecting something that they may be diagnosed with, to write down some generalized questions and then write down the answers as they receive them from the doctor.”

Thoughts from the Physician

Dr. Annalyse Quintero was the first medical resident to participate in Ready or Not Role Play. 

“The first scenario started with the doctor coming in, so I was the first person to read something,” said Dr. Annalyse. “It was about test results and about [the patient] having CHF. The patient needed medication and needed to start a low sodium diet.”

“The point of this scenario was, you threw medical jargon at them that they might have not understand, like CHF, without explaining what it meant- Congestive Heart Failure. You threw in starting a low sodium diet without explaining to them what it was for and why. And, you started them on a medication when they probably didn’t even know what a diuretic was or why they needed it.”

“We got to talking about how, most of the time, if you just walk in and start talking about having the results to the patient’s tests, people don’t remember what tests [the physician] ordered,” said Dr. Annalyse. “Sometimes it’s hard for [the patient] to know and make the connection that they were sick and therefor the doctor was ordering tests.”

“After the scenario, the seniors were able to comment on what they thought could have been done better and I was able to comment on what could have been done better, but also answer any of their questions in regards to what they could have done to make the visit go better.”

“A lot of times they mentioned writing things down so they don’t forget,” said Dr. Annalyse. 

Participating in the Ready or Not Role Play program really allowed Dr. Annalyse to become more confident and comfortable interacting with older patients.

“Sometimes I would be too nervous to offer to write something down because I wouldn’t want them to be insulted that I was thinking they needed something to be written down in order for them to remember it,” said Dr. Annalyse. “The seniors responded that they weren’t sure if they could write it down, if they should write it down, or if they could ask the doctor to write something down for them.”

Firelands medical residents will be implementing these techniques as they complete their medical rotations at Family Health Services of Erie County

“A strong take way for me was, it’s on the doctor to not say things like ‘we are going to run a comprehensive metabolic panel on you’ because they might not know what that means. So physicians need to break things down.”

“I always tried to make sure I wasn’t going into appointments using big words that patients might not understand, so this just kind of solidified that. Going forward I probably won’t be so hesitant to ask if someone wants me to write something down for them and to make sure I’m not talking too fast.”

Serving Our Seniors

After participating in this program, Tina Elmlinger hopes that seniors feel confident in their ability to be assertive with their health care needs because they are the consumer. And to understand that the more prepared you are before you go into an appointment, the better the appointment will be.

Are you interested in participating in a future Ready or Not Role Play? All Erie County residents over the age of 60 are eligible to participate. To register call Tina at 419-624-1856.

Serving Our Seniors is dedicated to creating a full spectrum of quality services for older adults living in Erie County, Ohio, which will assist them in maintaining their independence, and enable them to live full, active, healthy lives in their own residence. Their advocates have the training and experience to help with any questions, concerns, or problems someone might be experiencing. If you are struggling with health, food, medicine or utilities costs, need transportation, or just have concerns no matter how small you might feel they are, call a Serving Our Senior advocate today at 419-624-1856.