Close up photo showing an elderly person's hands on a cane

The trust older patients place in doctors can compromise their medical care: study

Placing trust in doctors to advocate for their health needs, older adults rarely ask for referrals to specialists, specific prescriptions, express concerns or follow-up after medical visits, according to a new study from Case Western Reserve University.

The findings highlight a disconnect between the expectations of older adults and the realities of a changing health care system, where doctors have less time to spend with patients.

Eva Kahana
Eva Kahana

“These findings are concerning,” said Eva Kahana, Distinguished University Professor and Pierce T. and Elizabeth D. Robson Professor of the Humanities at Case Western Reserve. “Our data suggests older generations are clinging to how health care used to be, when doctors had more personal relationships and continuity with patients.

“When patients incorrectly assume actions and advocacy by doctors, this leads to major problems,” Kahana continued, “especially for older adults living with one of more chronic illnesses, such as diabetes and high blood-pressure.”

The study shows that older adults (defined as 65 and older) are less likely to advocate for their own health concerns the more they trust the role is being taken on by their doctors.

The findings are especially relevant for minorities and the sickest of patients, who have less access to health care and face particular challenges in finding responsive care, according to previous research.

Among of the study’s other findings:

  • Older adults who feel comfortable advocating for their own care feel more empowered;
  • Compared to white patients, African-American patients were less satisfied with their physicians;
  • Latino patients expressed greater satisfaction with their medical care than white and African-American patients;
  • The perceived emotional support of physicians was associated with patients’ satisfaction.

“Our findings strongly suggest that families of older patients should be ready to step in as advocates for their older relatives,” Kahana said. “And it’s helpful for doctors to be more aware of how older patients see them.”

Published in the journal Clinical Interventions in Aging, the study is based on data from a diverse pool of 806 older adults from a large retirement community in Clearwater, Florida, and others in Orlando, Miami and Cleveland, where Case Western Reserve is located.

Lead author of the paper was Boaz Kahana, professor of psychology at Cleveland State University; co-authors include Kaitlyn Barnes Langendoerfer and Jiao Yu, both graduate students in sociology at Case Western Reserve. The research was funded by the National Institutes of Health.


For more information, contact, Daniel Robison (daniel.robison@case.edu).