Being Truthful When Receiving Health Care – Why seniors may not be upfront and what can be done about this?

Caregivers often express concern that their loved ones aren’t necessarily being totally truthful in talking with health professionals when they seek medical care. When they are with their caregiver, they may complain about pain, express frustration, or show memory deficits. But when they meet with their doctor, there is a notable difference in what they reveal. The patient often has nothing to complain about and is happy to tell their doctor that they have no concerns and everything is just great.

My mother was no exception. She would turn on her charm and tell the doctor that she was perfectly fine despite hiding her valuables in the trunk of her car because she thought people were stealing from her. She stayed up all night with constant worry and stress. And despite not exercising for years, she would tell the doctor that she climbed the stairs of her assisted living facility several times a day and regularly spent at least 30 minutes using the treadmill in the exercise room. She also told the doctor that she had no problem taking her daily medicine when I knew that wasn’t really the case either. I can’t tell you how many times I was called to try to convince her to take her medicine and how often I drove to her facility to talk her into taking pills.

Why do seniors act this way in front of a physician? Is it a common phenomenon?

A recent study developed by physicians, psychologists, and researchers reported that 60-80% of participants don’t reveal the truth at some point in their contact with their doctors. They may omit some details or fib a bit; they may even consciously lie.

A major reason is a fear. People don’t want to be told they have a serious illness or disease. Seniors specifically, don’t want to lose their independence whether that is living in their own home or driving their own car. And if it relates to a mobility issue, they may not be open to using a walker or wheelchair. So, in their minds, it’s best to just tell the doctor whatever sounds good. Basically, they deny reality so they can believe what they want to believe.

There are other reasons that patients aren’t totally truthful. The topic may be too uncomfortable or sensitive for them so, it is far easier for them to avoid it completely. They may not understand the doctor’s instructions or disagree with their findings and/or recommendations. For example, they are tired of all of the medical appointments and medications.

Or they may be leading an unhealthy lifestyle and don’t want to disclose the truth about their patterns of irregular or non-existent exercising, unhealthy diet or binge eating, excessive drinking and legal/illegal drug use, incidences of falling, taking their medications incorrectly, and so on.

Let’s face it, it is hard to admit failures or mistakes. And who wants to be judged or lectured? In addition, they don’t know how the doctor is going to react. Many are simply too embarrassed to admit the truth. In some cases, they may not really know that something is unsafe or problematic.

Despite these misgivings, none are helpful.

What can you do as a caregiver to help inform the doctor of your loved one’s condition so they can receive the best treatment, and at the same time, treat the patient with the respect they deserve?

Some suggestions as a caregiver for helping the senior communicate more openly and honestly with doctors

As a caregiver, you can…

Talk to the patient before the appointment and encourage them to tell the doctor what they really feel. Share with them that physicians are there to help them so they need to confide in them so they can get the right treatment and feel better. Repeat this conversation a few times so hopefully, it sinks in.
Tell the seniors that you are there to help them and that you are on their side. Keep an eye on their medical and emotional issues. Reassure them that you want to get the best help for their health and safety.
Share a story or article with them about the topic you want them to discuss with the doctor to get them in the right framework and help them identify with others who are going through similar situations. Or ask them if they know others (e.g., maybe their parents, a relative or a friend) who are having/ had the same issue and discuss what was done or could have been done to help the issue.
Call the doctor before the appointment and tell them of your loved one’s symptoms and behaviors, etc. so they know what to address when you meet face-to-face or talk to them privately during some part of the appointment. Or you might consider writing a letter or email to the doctor to relay your concerns. Each of these suggestions offers an opportunity for the doctor to get the facts and allows them time to prepare, arrange for additional testing, or consider a referral to a specialist while keeping your input in confidence. Remember, you will need to have authorization or a valid medical power of attorney document to discuss the senior’s health with the respective medical professionals.
Keep a daily record with dates and times that tracks any concerns with behaviors and health issues.
Bring a detailed list of any prescriptions, over-the-counter medications, vitamins, and herbal supplements along with the current dosage that the senior is taking. This will help with prescribing new medications and realizing possible side effects, etc.
Try to include your loved one in the conversation during medical appointments as much as possible and when appropriate. Look at them, smile, offer a gentle touch, explain clearly, ask for their feedback, etc. so they feel included and may be more apt to open up and get the help they need.

Some suggestions as a health professional for helping the seniors communicate more openly and honestly with them

As a health professional, you can…

Make time for your patient
State your main intention is to help
Treat them with respect and dignity
Be personable
Listen attentively
Look them in the eye when conversing
Sit on their level
Have meaningful conversations
Ask open-ended questions but keep tightening up the questions
Probe in a careful, nonjudgmental way when asking questions
Watch for non-verbal clues (e.g., long pauses before answering, fidgeting, anxiety)
Schedule consistent care to build a stronger relationship, a sense of comfort, and an opportunity for ongoing rapport

Why is “being truthful” when receiving health care such an important topic?

When patients withhold information or stretch the truth, doctors can’t give the most accurate medical advice. They may misdiagnose and undertreat significant health problems. And when medical professionals don’t attempt to take the time and truly listen, they may jeopardize the doctor-patient relationship so that the patient is reluctant to give straight responses. Both instances can have profound implications for the senior’s ongoing health and their quality of life.

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