In the past, elderly patients were often treated like children, given instructions supposedly for their own good without any real discussion and moved around without much in the way of consent. Today, all that has changed. First and foremost, patients must be recognized as individuals to be treated with respect. Managing that while providing adequate support isn’t always easy, though, and sometimes what’s simply intended as sympathy can come across in the wrong way. How can you get the balance right?
Put yourself in the patient’s position
The simplest way to ensure patients’ dignity is to imagine how you would feel in their position. This doesn’t solve everything – not everyone’s needs, or feelings, are the same – but it does mean that you’ll remember you’re dealing with human beings who value their privacy and personal space no less because they happen to have clinical needs. It will make it easier to realize when you are at risk of crossing a line and need to approach something with more caution, whether you’re administering medication or providing intimate personal care.
If you’re not sure how to handle a situation so that your patient feels safe and comfortable, the best way forward is to ask. It’s good for primary care nurse practitioners to show confidence because this helps to put patients at ease, but that doesn’t preclude inviting patient input. Letting people know that it’s okay to speak up if they feel uncomfortable about something and that you’re never going to treat the matter as trivial helps to give them the confidence that they need. Inviting their suggestions sometimes produces useful solutions you wouldn’t have considered.
Let them stay in control
Most elderly patients are as capable of making decisions about their lives as anyone else. Even those suffering from dementia or the after-effects of stroke can exercise some level of control if given the chance. Even complex medical decisions can be explained in simple ways so that the patient is part of the process. Day to day decisions, like how they are moved around, what they are given to eat and who washes them, should never be peremptorily taken away from them.
Remember every patient is different
On top of the issues that come with getting older, every patient has different personal issues to consider, and failing to take these into account can make their experience very distressing. It’s important to make sure that food meets their cultural and religious needs, for instance, and to avoid making assumptions that play into prejudice, leaving patients with minority identities feeling marginalized and unwelcome. Make it clear that you’re always ready to listen, and let patients lead the way.
If you’re doing a good job of listening and inspiring patient trust, small mistakes will be easily forgiven, so you don’t need to walk on eggshells all the time. Patients will know when you’re on their side – just make sure they can see you looking past their medical needs at the people they are underneath.