Features of forming trust in communication with elderly and senile patients

BACKGROUND. Methods for slowing down aging processes and progressing of age-associated diseases are being extensively studied. To make significant discoveries in this area, scientists need data on elderly patients, primarily as the target subject of the research rather than a subgroup in the general sample of all ages. Meanwhile, doctors face difficulties in establishing and maintaining longterm contact with elderly patients both at the stage of inclusion in the study and during examination and treatment. Ignorance of the specifics of communication with elderly patients often leads to a complete loss of the patient’s trust and the cessation of interaction with the doctor.

AIM. To describe key elements of interaction with elderly and senile patients and to identify tools for establishing trust during the initial conversation.

MATERIALS AND METHODS. A cross-sectional observational study design was used to collect and analyze data from the initial interaction between the doctor and elderly and senile patients. RESULTS. A total of 166 people aged 65 to 90 years (median age: 77 years) underwent primary screening before inclusion in the clinical trial, which included medical history collection, examination, and assessment of available laboratory and instrumental data. All participants were informed that the study would require a noninvasive examination to assess vascular stiffness and a single blood draw from a peripheral vein. Despite full compliance with the inclusion/exclusion criteria, 42 patients (24.7%) did not sign informed consent for participation. When analyzing the reasons for refusing to participate in the study (data was indicated voluntarily in the questionnaire without the presence of a doctor and/or in person at a doctor’s appointment), the most common reasons were as follows: fear of fraud, fear of the need for repeated interactions (it would be necessary to come regularly to give blood / perform other invasive procedures), unwillingness to learn additional information about the state of their health and prognosis, fear of the personal data use outside the limits of medical purposes; the reason for not wanting to “create a medicine/weapon based on my blood” was also repeatedly indicated. In 63% of cases, elderly patients tried to transfer responsibility for a decision to their relatives or the doctor themselves. The main reasons for voluntary consent to participate in the study were as follows: hope for additional attention from medical personnel, the possibility of additional direct contact with a doctor (without an appointment), altruistic reasons.

CONCLUSIONS. Lack of trust in communication between doctors and elderly/ senile patients is a major issue in the medical environment. Building trust in the healthcare sector is crucial for forming effective long-term relationships with patients. Empathy, patience, transparency and medical expertise are the key pillars of trust for elderly patients. Methods of active listening, clear communication, limiting the use of medical terminology, predictable schedule in communication contribute to increasing empathy and transparency in the relationship and thus to building trust. Constantly updat of medical knowledge and providing a second expert opinion demonstrates the medical experience of the doctor to the elderly patient and also contributes to building trust.