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Older adults are skipping necessary care. Here's how to change their minds.

By Rachel Zuckerman

June 11, 2020

    Patients worldwide have delayed seeking the care they need for chronic and urgent conditions during the new coronavirus pandemic. That's because they either don't want to overwhelm the health care system or are afraid to go to the hospital for non-Covid care.

    Global edition: Ready-to-present slides on the latest geriatric market trends

    While this is an understandable public reaction to an infectious disease, it's also extremely worrying, especially when we consider how detrimental missed care can be for the already complex elderly population, as they are likely to have multiple chronic conditions and are at an increased risk of fatality from Covid-19.

    Older people a blind spot in post-Covid world

    Based on historic and projected utilisation data, as well as demographic data, we know that older people are in growing need of specialist support—and yet, right now they're not getting it.

    From 2017 to 2022, we project a 12% growth in inpatient cardiovascular demand and 21% growth in inpatient general medicine demand from the elderly alone (defined as patients aged 65+). But this care burden isn't reflected in today's geriatric admission numbers, pointing to a serious blind spot.

    It doesn't help that even under 'normal' circumstances, geriatric patients are less likely to think their condition is severe enough to visit the hospital emergency department (ED). In a consumer survey we conducted in England, less than a fifth (19%) of older adults said they went to an ED because they thought their condition was severe enough to warrant the visit, compared to almost a third (27%) of patients under 65.

    This tension is further complicated by governments who have asked older people to stay at home and shield themselves, as providers are recognising the importance of encouraging people to start to come back for care. Below we outline what geriatric providers should be communicating to their patients and how best to do so.

    What to communicate to older adult patients?

    In an interview with ReviveHealth, our colleagues point out that to overcome fear, patients need to hear how health systems are keeping them safe and they need to hear it often. In fact, a survey reveals that getting messages from providers twice a week was deemed an appropriate amount of communication by respondents. We also found that answering patients' most frequently asked questions (FAQs), alongside sharing information on safety protocols, encourages them to seek the care they need.

    In addition, providers should educate geriatric patients on alternative access points, since they may be less comfortable using these options than younger patients. For example, providers must make sure older patients are aware of and know how to access virtual care and outpatient facilities, which they are likely to feel more comfortable using than coming to an acute inpatient site in person.

    What's more, the COVID-19 Concern Index found that elderly women are almost three times more likely than men in the same age group (37% vs 13%) to say they would 'definitely' postpone a procedure today. This means that providers need to place an outsized effort into clearly communicating to patients all the available ways of accessing older women's services across the health and care system.

    But it's not just the content of your messaging that matters—it's also how you share that information with your patients.

    How to communicate with older adult patients?

    A successful communication strategy for the elderly requires a deep understanding of the geriatric population's unique health care preferences and what sources of information they rely on. So who do they trust?

    The elderly patients we surveyed in England cite general practitioners (GPs) as their most trusted source for information. In fact, they told us that the primary reason why they sought urgent care was because their GP recommended they should do so. We see a similar level of reliance on GPs among the geriatric population across other regions, including in Australia where two thirds of geriatric patients (64%) reported trusting their GP for information on potential surgical providers. Younger patients, on the other hand, reported consulting a much more diverse range of sources when picking a surgeon, relying less on GP recommendations.

    With that in mind, once your facility has determined it's safe to reopen and has protocols in place to ensure patients are at low risk for infection, providers need to invest time in developing a targeted communication strategy to help geriatric patients access timely care.

    In this particularly uncertain time, it's not enough to send a general email saying, 'We're open for business'. Instead, consider asking trusted sources of information—GPs or other doctors—to share the necessary details on your health system's infection control protocols and answer FAQs in order to slowly ease concerns surrounding hospital-based care.

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