Elderly patients with OA may think physical activity is counterintuitive when they are in pain, but activity will help avoid weight gain, help prevent falls, and improve the OA symptoms, Dr. Altman says.
Rheumatologists, as well as other clinicians and caregivers, should work with geriatric patients to reduce their risk of fractures due to falls, Dr. Altman says. Remind caregivers to check the living environment for poor lighting or furniture hazards, such as rugs that can be tripped over.
Effective Patient Communication
Although effective patient communication is crucial with any patient population, it is especially important with older patients, who may also have vision, hearing, and cognition problems, says Helen Osborne, MEd, OTR/L, founder and president of Health Literacy Consulting in Natick, Mass. Osborne is author of the book, Health Literacy from A to Z (Jones & Bartlett Learning; 2nd edition, 2011).
Additionally, declining literacy skills, pain levels, independence issues, language barriers, culture, and emotion can all play roles in an elderly patient truly comprehending how they should manage their rheumatic disease. “It’s not just about understanding a brochure,” she says. “The patient has to learn, act on, and internalize information.”
Rheumatologists should make it a team effort to educate geriatric patients—or for that matter, any patients—about their disease, Resnick says. “The rheumatologist didn’t go to medical school to repeat patient education numerous times,” she says. “It takes a team effort.” Designate other staff members to help reinforce instructions and reiterate the important health promotion and disease modifying information that is critical to managing rheumatologic disease, Resnick says.
At the same time, during a visit with a patient, the clinician can try to match the patient’s language to make communication more effective, Osborne explains. For example, if the patient is using the phrase “water on the knee” to refer to knee effusion, you may want to match the patient’s terminology instead of using technical terms.
When describing conditions or providing instructions on how to take medication or how to perform certain exercises related to the patient’s rheumatic condition, “communicate that message consistently along the continuum of care,” Osborne advises. For some patients, this will include family members, home health staff, physical therapists, and other health professionals.
Osborne also recommends providing patient education in a variety of methods. In addition to brochures, consider visuals, audio and video, or manipulatives such as a model skeleton. “There’s no one-size-fits-all when it comes to patient education,” Osborne says.
