Understanding The Whole Story: Assessing Doctor-Patient Communication with Older People in Acute Care

Abstract Background Communication is the cornerstone of our interaction with people. Effective doctor-patient communication is central to building a therapeutic doctor-patient relationship. Some older patients may have challenges with communication due to hearing loss, various co-morbidities, and possible cognitive impairments. However, there is limited Irish research into understanding specific communication challenges. Our objective was to explore doctors’ and older patients’ perceptions of hospital-based communication and to identify perceived aids and barriers to effective doctor-patient communication. Methods A cross-sectional study design was used. Two previously validated Doctor-Patient Communication Scales (one for patients and one for doctors) were utilised to assess our two groups, inpatients aged 65 years and older and doctors treating this population. The questionnaires included similar questions about doctor-patient communication, with some variations to suit the different populations. Quantitative data was generated by graded responses (Likert Scale 1-4). A qualitative component was additionally incorporated into both questionnaires to explore perceived communication barriers, time spent by doctors per patient, and prior training received in communication. A total of 100 in-patients and 38 doctors participated. Results Patients reported a mean communication score of 42.27/52 (SD=8.35); doctors averaged 39.21/44 (SD=3.11), suggesting generally positive perceptions. However, a significant negative correlation was found between patient scores and number of co-morbidities (r = -0.327, p < 0.001), indicating poorer communication experiences among patients with more conditions. Notably, 43% of patients had difficulty understanding their doctor. Cited barriers included time constraints, hearing impairments, hospital noise, medical jargon, and doctors’ varying accents. Among doctors, 39.5% had not received post-graduate communication training. Positive influences on satisfaction included doctors’ friendly demeanours, involving patients in decisions, and use of clear, simple language. Conclusion Doctor-patient communication must be improved for older adults with complex needs. Addressing key barriers—such as limited consultation time and insufficient communication training—may enhance patient understanding and outcomes.