Seven ways nurses can deliver high-quality care to older patients

Every patient is unique, and one of the major skills good nurses possess is dealing with all issues with patients effectively. 

Some patients are aggressive, some are too closed off, and some might be very stubborn. One of the problematic areas, especially for new nurses, is handling older patients. 

Age-related impairments like Alzheimer’s, dementia, hearing loss, vision loss, and various personality changes often make it extremely difficult to ensure high-quality care for elderly patients. 

Since seniors experience a loss of independence and deal with family conflicts, these issues are expected.

Each elderly patient is unique, and it takes a good amount of knowledge about them to establish a connection. 

It is necessary that you avoid generalizing and making assumptions, especially regarding their ability and competence. 

Not everyone suffers from age-related problems, and if you assume every patient does, it might frustrate older patients. 

The following tips will help you overcome such hurdles and deliver high-quality care.

1. Be patient

Patience is one of the key traits any nurse should possess. You will have to repeat yourself repeatedly and deal with patients who refuse to listen, don’t follow instructions, or are just plain stubborn. 

Especially because of auditory and cognitive impairments that most elderly patients have, they will need time to understand what you are communicating. 

Talk slowly and patiently, notice whether the patient is following, and repeat yourself wherever necessary without frustration or impatience.

Patience is also one of the most important bedside nursing skills you will learn as a nurse. When you work in the front, providing direct patient care, your interaction with the patient is crucial. 

Whether you work as a registered nurse, an advanced practice registered nurse, or a licensed registered nurse, know that you will most likely have the greatest interaction with the patient. 

Your strategy can also influence their later healthcare decisions.

2. Give respect

Elderly patients already embittered because of their decreased independence don’t react well to disrespect and patronization. 

Keep in mind that there will inevitably be differences of opinions between you and them because of the generation gap. 

There will be beliefs that you disagree with. Respect their views and find rational strategies for resolving issues when such beliefs interfere with care provision.

Another way of communicating respect to an elderly patient is to be mindful of how you are addressing them. 

Often adding the title of Mr., Ms., or Mrs. is sufficient, but if you can ask the patient about their preference, it would be better. 

Secondly, while you might be used to calling young patients’ dear’ or ‘hon,’ avoid this with the elderly because it would sound condescending to some.

3. Develop a rapport before you proceed

When you first interact with an elderly patient, do not dive right into the important stuff. Take some time to establish a rapport so that the information you deliver is received well. 

Begin by introducing yourself and convey to them that you care about their opinions. Don’t let the first meeting be loaded with too much information about yourself.

Instead, include questions about their family, interests, hobbies, etc.

Research suggests that rapport is built almost completely during the first meeting but can be developed throughout treatment. 

Initial trust is crucial, but so is sustaining such a rapport throughout.

4. Monitor your language

One common barrier when it comes to older patients is language. Often words you use casually have different connotations for the elderly because of the generational gap. 

Be mindful of what words you might be using that the patient could take differently. For instance, dementia today is used as a medical jargon for psychological impairment, while in the past, it connoted insanity. 

If you use such words carelessly, the patient can take offense and become oppositional. Similarly, cancer could, for the patient, mean inevitable death. 

Therefore, try to use simple language and don’t assume that the patient knows what you mean; clarify as much as possible to get the right meaning across. 

Also, offer to elaborate on anything the patient does not understand.

Using technical jargon can also be problematic when dealing with an elderly patient with a comprehension problem or low literacy. 

Your focus should be on getting the message across to the patient as clearly as possible.

5. Lookout and compensate for hearing impairments

Research suggests that a quarter of those aged 65 to 75 suffer from hearing loss. You must recognize hearing impairment before diving into the main problem’s medical details. 

When dealing with a deaf or hard of hearing patient, begin by ensuring the patient hears you well, using a hearing aid or in a loud voice. 

However, avoid shouting or raising your voice too much as this only distorts language and can communicate anger. 

Allow for easy lip reading by looking straight at the patient and not covering your face. Also, minimize background noise and use your visual cues to facilitate communication. 

To keep track of whether the patient is following, repeat yourself, rephrase, and ask the patient whether they understand. Use a notepad to get the message across wherever you feel the need.

6. Use active listening

As important as it is to communicate important information to the patient, it is equally necessary that you provide your patient with a listening ear. 

Elderly patients are already likely to feel neglected and ignored. Don’t worsen this feeling by giving their words no importance. 

You might have difficulty understanding what your patient is saying but make a genuine effort to know what they are trying to say. 

You should give affirmative nods and maintain eye contact to show them that you follow.

7. Communicate empathy

By being sincerely empathetic to the patients’ concerns, you can establish a strong rapport. When the patient feels understood and cared for, they come to trust the healthcare workers. 

Recognize and acknowledge the difficulties your patients might be feeling and put in a sincere effort to understand their concerns. 

Ageist stereotypes and negative connotations associated with the elderly should not interfere, and you should treat all patients equally empathetically.

Final words

Every once in a while, you are likely to encounter an elderly patient with different views and attitudes. 

When dealing with such patients, be patient, show respect, monitor your body language, practice active listening, and be empathetic. 

Every patient is unique, and your interaction with them will influence health outcomes, so carefully monitor your responses.