AARP Hearing Center
Multiple AARP Research surveys have reported that older adults experience ageism in health care. One survey noted that nearly six in 10 older adults (58%) say age discrimination happens "some of the time," while another found that nearly one in four older adults say their (or a family member’s) medical concerns have been “minimized, ignored, or dismissed during care.”
Given the rapidly growing population of adults 50 and older who will require increasing levels of health care in the years ahead, it is now more important than ever to remove ageism from the equation. Fortunately, initiatives are already taking hold, and tools in use are helping to change traditional approaches to health care, not only for older adults but for everyone. They all start with the recognition that a clinician and all health professionals must understand what matters to the patient, as described in the first blog in this series on shared decision-making.
“Patient Priorities Care”: the importance of understanding patient priorities
All too often, health care professionals think they know what is best for their patients or, in the case of older-adult patients, they may discount their concerns as simply being “signs of aging.” When health professionals take the time to ask, rather than assume, what matters most to their individual patients—it becomes possible to improve the patient experience and outcomes for older adults. Additionally, health professionals need to shift from managing individual diseases in isolation to aligning care with older patients’ personal health goals and life priorities.
That is precisely what Patient Priorities Care (PPC) aims to do. PPC is a national effort to develop and test an approach to health care that aligns clinical care and decision making with the specific health priorities of older adults who have multiple conditions. PPC’s resource, My Health Priorities, offers a user-friendly platform where older adults are guided through a questionnaire that helps them identify their life and health values; specific and actionable value-based goals they most want their health care professionals to help them achieve; their health care preferences (i.e., what they are willing and able to do for their health and what they find difficult or unhelpful); and their top priority (i.e., their most bothersome health problem impeding the health goal they most want to focus on). See video here.
PPC has been successfully implemented by health professionals across various settings, as well as by health care systems such as the U.S. Department of Veterans Affairs (VA) and the Program of All-Inclusive Care for the Elderly (PACE).
A PPC case study by Dr. Katherine Ritchey and her team at the VA Puget Sound Geriatric Research Education and Clinical Center demonstrates that by focusing on what matters most to patients, clinicians can meaningfully improve care for older adults and contribute to healthy longevity.
“Systems-wide, it really takes shared decision making to another level,” says Ritchey. “PPC takes values and turns them into something tactile and useful that you can anchor treatment decisions around.”
An expanding movement: the power of shared decision-making
The PPC work represents a segment of a broader movement for patients and their clinicians to share in the decision-making of the patient’s treatment goals and care plans. For example, PPC’s My Health Priorities complements and expands upon the Institute for Healthcare Improvement (IHI)’s My Health Checklist.
The implementation of these resources represents crucial steps in aligning health care with the individual priorities of older adults, ensuring their voices are heard and acted upon. When health care professionals align their care based on each older adult’s priorities—and take their needs seriously—then we can more meaningfully address the health concerns of the aging population.
A forthcoming blog in this series will take a closer look at My Health Checklist and how it is implemented in the community to reach older patients.
Lynn Mertz is a senior strategic policy advisor with the AARP Global Thought Leadership team.
Dr. Mary Tinetti is the Gladys Philips Crofoot Professor of Medicine at Yale University School of Medicine. Her current research and clinical focus are on clinical decision-making for older adults in the face of multiple health conditions and disseminating an approach to decision-making aligned with each person’s health priorities.
Crystal Gwizdala is an associate communications officer at Yale University School of Medicine, supporting Patient Priorities Care, the Geriatric Workforce Enhancement Program (GWEP), geriatrics, endocrinology and metabolism, and infectious diseases.
Jessica Esterson is the project director for Patient Priorities Care and the Geriatric Workforce Enhancement Program (GWEP) at Yale University School of Medicine.
MORE FROM AARP
