Whose responsibility is it to remind older adult patients of their next programmed appointment?

Let’s say a patient is supposed to have an in-office procedure every six months. For whatever reason, that appointment was not booked in advance.

In a perfect world, both the physician’s office and the patient would share responsibility for ensuring the patient adhered to their treatment plan. The office may explain to the patient that they need to make a repeat appointment in six months, and the patient may put a notation on their calendar to make that appointment in the future.

But is that enough?

A patient’s memory of medical information is essential for complying with a treatment plan. Studies show that 40-80% of medical information a healthcare practitioner provides is forgotten immediately, and almost half is remembered incorrectly.

The way the information is relayed also affects recall. For example, medical information that is spoken is less effective than providing information in writing.

Also important is whether the information is presented in an organized fashion. 

Non-organized medical information is more in line with how patients receive information today - test or lab results at one point, conversing with various healthcare practitioners at another, and then a final diagnosis and treatment plan after that. Memory fades over time, and a long gap in receiving information can significantly affect medical compliance.

Stress and anxiety can also impact the recall of medical information. In the case of an older adult that prompted me to write this column, the every-six-month procedure mentioned is painful and engenders stress and anxiety. Those feelings could have contributed to the patient forgetting to book an appointment for over 18 months and missing three treatments. 

When the patient finally called for an appointment, thinking it had been a long time since her last one, she learned the physician had retired. Her chart had been transferred to a new group taking over the doctor’s practice. This changeover probably resulted in no one calling her to remind her of her every six-month procedure.

The 18-month wait resulted in an outcome that was very unpleasant and painful for the patient. At 88, she was lucky to be resilient enough to withstand the procedure without long-lasting effects.

Her experience does beg the question of how medical practitioners are trained to communicate medical information to older adults, and what responsibility they take in communicating with the patient to help ensure compliance.

While we can’t necessarily change how a healthcare provider communicates, we can change our behavior.

Some suggestions:

• Bring a friend or partner to be an extra set of ears.
• Ask for written instructions whenever possible.
• Since appointments are often booked out in advance, book your next appointment while you are at the doctor’s office.
• Keep a paper calendar at home to write in appointments and double-check appointment reminders.
• When in doubt, call the physician’s office to see when you are due for your next appointment.
• If a procedure is particularly painful or results in a secondary injury, ask if pain medication or antibiotics are appropriate.
• Speak up if you are anxious or stressed.

Retaining medical information can be a key challenge in older adults’ healthcare.  Combining some of the strategies above can improve our ability to retain and act on critical medical information.