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For Caregivers, Little Fixes Could Help a Lot

A recent article shows how seemingly mundane problems affect care

By Robert L. Kane MD

An important story in this week’s medical journal BMJ (formerly the British Medical Journal) reminds us about the human side of caregiving.

David Gilbert relates the trouble he had taking his mother, who lives in a nursing home, to see a specialist in Britain's National Health Service. The only appointment they could get was early morning. Preparations involved getting his mother up and dressed very early, but then they spent 90 minutes looking for a parking spot.

As a result, they barely made the appointment (fortunately the doctor was running behind). His mother was understandably agitated and, as a result, then could not understand or respond adequately to the doctor’s questions. Gilbert says she may have gotten the wrong prescription because the doctor did not get the full picture of her problem.

(MORE: Why Elder Care in America Isn't Working)

A Caregiver's Wish List

So, in an era of patient-centered care, should car parking be an element of quality? Or more generally, should clinics be more aware of just how user-unfriendly they can be, especially for frail older patients?


Sometimes the small things we take for granted (or assume are not part of our jobs) can make a big difference in setting the tone for clinical communications.

As medical care becomes more competitive, we’re seeing more concierge services, such as valet parking and guides when you arrive. And that’s a good start. 

Now, if only we could do something about the stark waiting rooms with outdated magazines. Why not use that long waiting time to encourage patients to write down questions they have or complete questionnaires that can update their health status and help them become more active participants in their care?

We also need more attention to design in doctor’s offices. Persons with disabilities (including some older patients) have trouble climbing onto examination tables. Older patients put into those horrible gowns that flap in the breeze may be left on their own in a cold examining room. Surely, we can all do better.

Robert L. Kane MD, MD holds an endowed Chair in Long-term Care and Aging at the University of Minnesota School of Public Health. He is an internationally recognized expert on the care of older persons. He is also part of a group called The Long-Term Care Re-think Tank, and is doing all he can to change the way our country currently delivers care. Read More
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