Practice Management Alert

Find out how language can be the key to ensuring patient comfort.

Your practice may provide care to all kinds of people, including the elderly. Check out these language tips to make sure you're treating your older patients with respect, as well as providing the care they need.

Even if geriatric people make up only a small percentage of your daily appointment schedule, your colleagues - from front-desk receptionists to physicians - should know what language to use and what tones to avoid. Though a lot of this may seem like common sense, it's worth reinforcing the importance of language in your practice. Plus, team members may be committing these snafus without realizing.

Pioneer Network, in Rochester, New York, is committed to changing the way the medical and skilled nursing institutions treat elderly people. Get on board with some of its ideas for some basic but meaningful changes in your practice's relationship with patients and dialogue with these tips, pulled from "The Power of Language to Create Culture" by Judah Ronch, PhD, and Galina Madjaroff, MA, faculty at University of Maryland, Baltimore County, in Baltimore.

Adjust Your Tone

Team members may not realize that they change the way they talk when speaking with elderly or disabled patients, but many people do. The biggest things to watch out for are using different words, pitch, or speed of speech, Ronch and Madjaroff say.

Here are some tones and speech patterns you and team members should avoid:

• Baby talk.
• Accommodative speech: Don't fall into the habit of making the pitch of your voice higher, exaggerating the pronunciation of words, or slowing your speech when talking to people in your care. It's definitely OK (and often necessary) to speak more loudly, especially if a patient experiences hearing loss.
• Institution-speak, such as employing "we" instead of "you" when speaking to those in your care or employing terms of endearment that aren't organically felt.

o For example, on a wintry January morning, a team member goes out to fetch Mrs. Johnson, a patient in her late 70s, to bring her into exam room 2. Mrs. Johnson is wearing a winter coat and hat and mittens, just like all of the other patients in the waiting room. The team member enters the waiting room and exclaims, "Hi Mrs. Johnson! Wow, aren't we bundled up for the snow this morning? We're ready for you; right this way!"

• "Elderspeak," which is a variation on baby talk, and can involve lots of "cutesy" words that end in "y," as well as "words or phrases that reinforce ageist stereotypes that suggest that aging is the same thing as deterioration or failed adulthood," say Ronch and William Thomas, MD.

Interestingly, even the way physicians, nurses, physician assistants, and nurse practitioners gather crucial health information can affect how they treat patients, especially geriatric patients.

The tradition of documenting health condition or diseases with the use of "measurable, precise quantified methods for readily measured biological areas of life (i.e. bowel and bladder output, pain intensity, medication records, treatment records, meal intake records) has made the language of work ... emphasize the information communicated through the vocabulary of science and technology, and confers its high status on those who master the scientific language, such as the doctors and nurses," Ronch and Madjaroff say.

That means that medical professionals may be taking too much agency of controlling one's own health out of patients' hands, as they discuss aspects of basic health in terminology that may not be accessible to everyone.

Adapt Language and Dialogue

Consider this difference in language in all areas of your practice.

Physicians and nurses: Remember, you're not asking patients to talk about any discomfort for the sole purpose of adding problems to their health records, but because you want to help them become as comfortable as possible. The quantifiable measurements of health are useful, clinically, but may not tell a patient's medical story as well as her words.

Front-desk and other frontline staff: Try to accommodate older patients as much as you can, without accidentally belittling them for their needs. It's perfectly OK (and considerate) to walk any paperwork to and from an elderly patient in the waiting room, especially if she struggles with mobility. And you should feel empowered to speak loudly if a patient struggles with hearing loss. But be wary of assuming that all older people face the same struggles.

Get to know your patients and their needs to ensure that you provide high-quality care in a comfortable, respectful atmosphere.