Caregivers represent what is possibly the most readily influenced group for healthcare organizations wishing to improve their engagement levels with seniors. We've talked before about how nearly 4 in 10 US adults provide care to a loved one; many of these elderly patients rely solely on caregivers to make their health decisions for them. And accordingly there's been much written and much said about how caregivers can develop a more collaborative relationship with their loved ones' providers. But what if we put the shoe on the other foot for a moment? Why must the onus be on caregivers to develop better relationships with physicians?
It shouldn't. At least, not exclusively. There are many ways to build productive working relationships between two parties, but in all cases, both parties must buy in to making that relationship productive. We need to develop more engagement strategies that focus on what providers can do to build trust with their patients and patients' caregivers alike.
Patients are living longer. But they're not necessarily staying masters of their own destiny longer.
According to the Centers for Disease Control and Prevention (CDC), the average life expectancy for an American aged 65 or older is 19.3 years. Now, assuming that a patient stays with his or her doctor from age 65 onward, that means a doctor could spend about half of his career managing the same senior patient's care. That's interesting, isn't it? When clinicians’ patients are in their late 60s, most don’t anticipate the possibility of such an extended caregiving relationship developing.
And though healthcare professionals probably do a good job of considering and including spouses in medical decision-making processes, some may not consider the development of an ancillary care relationship with patients' sons, daughters, or grandchildren.
The average age of most caregivers, however, may surprise you. According to AARP, almost half of all caregiving adults in the US are 49 years old or younger. Nearly a fourth are between 18 to 34 years old, nationwide. And for non-white individuals, the average caregiver age skews between 5 to 10 years younger: the number of African-American caregivers between the ages of 18-34 is fully double the number of Caucasian caregivers in the same age group.
In many cases, physicians need to consider that the person who will be the primary decision maker on a senior patient's behalf is only as old as, or younger than, the physician him or herself.
So, how can providers—and in particular physicians—better engage caregivers? How can they convey the information they need to convey without talking over the heads of, and thus alienating, caregivers and senior patients?
Lead less. Consult more.
In a seminal 1974 text, economist Victor Fuchs described physicians as the "captain" of a patient's health team. By 1982's edition, he envisioned the doctor as the "co-captain." And now?
"They’re just a member of the team," he told The Washington Post's Carolyn Johnson. "They’re becoming a member of the team who knows a lot more about some things than everybody else but a lot less than other people on the team.”
In other words, the physician's role is that of authentic expert—not all-powerful leader. Many doctors should consider listening more than they speak.
Leave behind the fix-and-forget approach.
So your patient needs a knee replacement. But it's not as simple as sending him or her to an ortho surgeon, referring for PT and OT then not thinking of the problem again.
What about the caregiver who has to help his or her mother to bathe or use the toilet?
What about the long process of loading a senior who has limited mobility into and out of a car for a series of therapy appointments?
What about the underlying condition that created the need for that knee replacement?
As we move away from a fee-for-service model, providers need to listen more to their patients— and to the caregivers who can often give a clearer, sometimes more objective long view of the situation—and consider the family's needs before developing a treatment plan.
Caregivers are our patients, too.
Healthcare professionals can no longer afford to say that they don't get paid to take care of entire families. In fact, they do—value-based and bundled payments are making that the norm. Understanding how to best engage caregivers will go a long way toward ensuring better outcomes.
c2b solutions included many caregiver questions in its 2015 market research study, the c2b Consumer Diagnostic. The study answered such questions about caregivers’:
Media, information source and communications vehicle preferences to guide outreach
Attitudes regarding the role of various healthcare professionals (e.g., physicians, nurses, pharmacists, etc.)
Family members on which caregiving is focused
Sources (bricks & mortar and online) for prescriptions, OTC medicines, Vitamins/Minerals/Supplements, both Usually and Occasionally
Plus many other data points and insights
Armed with these insights, a healthcare provider can better engage caregivers and align with them on excellent care.
Doctors need to value family caregivers as vital members of the care team. By helping them to provide the best possible day-to-day care, you can help minimize the number of times you'll have to attend to your senior patient in the office or, worse, in the hospital.