Simplifying Medical Instructions to Help Seniors

Gildasio S. De Oliveira, M.D., M.S., M.B.A.

The surgery is over, and in recovery, a doctor is explaining to an elderly patient how and when to take medication. It’s likely the patient is a little groggy and the medication is a high-risk opioid to ease pain. It is also likely that when that elderly patient gets home there is confusion about the doctor’s instructions on how to take a dangerous drug.

Now imagine that this elderly patient also has a low literacy level and lives alone. Without clear instructions and without the support of hospital staff, the odds increase for a mistake borne in confusion.

Because often it is the most high-risk medications involved, the implications of these mistakes can be serious. Here in Rhode Island, as across the region and our nation, the dangers of opioid abuse are frighteningly and painfully apparent.

The need and importance of simplifying instructions and providing support at home for elderly, low-literacy patients is clear. My research goals are focused on this challenge. As an anesthesiologist, researcher and teacher, I am working to find ways to reduce medication errors in low-literacy seniors, especially when opioids are involved.

Reducing medication errors begins at the hospital, even before surgery, and should continue through recovery and discharge. Plain language instructions, support post-operatively and after discharge should be examined. I believe the role of the anesthesiologist should follow the same course – engaged at every stage – taking action aimed at improving each and every patient’s recovery.

It is critical that patients, like physicians, recognize that what happens before, during and after surgery are all connected and related to successful outcomes. A patient is in the hands of the hospital staff during surgery but the success of their good work also rests on the patient’s ability to do their part after surgery and after discharge.

I offer this advice:

  • As a patient, or as a friend or relative of a patient, especially elderly patients, ask questions.
  • Request written instructions on how and when to take medications and make sure the patient understands those instructions.
  • Know who to call when there is a question, whether that would be a pharmacist, physician or other support staff.
  • Take advantage of translation services.

I am committed to keep working to find how best to ensure patients receive instructions they can understand after they leave the hospital and look forward to continuing that research at Lifespan.