Skip to main content
Top
Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Research article

Non-spouse companions accompanying older adults to medical visits: a qualitative analysis

Authors: Orla C. Sheehan, Anita L. Graham-Phillips, John D. Wilson, Deidra C. Crews, Cheryl L. Holt, Jennifer Gabbard, Katherine C. Smith, Jennifer L. Wolff, David L. Roth

Published in: BMC Geriatrics | Issue 1/2019

Login to get access

Abstract

Background

Medical Visit Companions (MVCs) are encouraged for older adults’ routine medical encounters. Little data exist on the experiences and contributions of non-spouse companions for the growing population of older adults without a living spouse.

Methods

We conducted six focus groups with forty non-spouse MVCs identified through churches in Baltimore, Maryland. Thematic analysis was used to identify key issues before the visit, during the visit itself, after the visit, and in the overall companion experience.

Results

MVCs described their experiences positively but also highlighted many challenges related to the role that extended far beyond the visit itself. These included scheduling, transportation, communication, and coordination of care expectations.

Conclusion

Our increasingly complex healthcare system can be challenging for older adults to navigate successfully. The diverse nature of tasks performed by companions in this study highlight the many benefits of having a companion accompany older patients to medical visits. The positive experience of the companions studied and their willingness to continue their role in the future highlights the untapped potential for increased social facilitation to improve the quality of healthcare visits and achieve patient-centered care for all older patients.
Literature
1.
go back to reference DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A. Health Literacy Universal Precautions Toolkit (Prepared by North Carolina Network Consortium, The Cecil G. Sheps Center for Health Services Research, the University of North Carolina at chapel hill under contract no. HHSA290200710014) Rockville, MD: Agency for Healthcare Research and Quality 2010. DeWalt DA, Callahan LF, Hawk VH, Broucksou KA, Hink A. Health Literacy Universal Precautions Toolkit (Prepared by North Carolina Network Consortium, The Cecil G. Sheps Center for Health Services Research, the University of North Carolina at chapel hill under contract no. HHSA290200710014) Rockville, MD: Agency for Healthcare Research and Quality 2010.
2.
go back to reference National Institute on Aging. Talking with your doctor: National Institute for Health Publication; 2014. p. 05–3452. National Institute on Aging. Talking with your doctor: National Institute for Health Publication; 2014. p. 05–3452.
3.
go back to reference Wolff JL, Roter DL. Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Arch Intern Med. 2008;168(13):1409–15.CrossRef Wolff JL, Roter DL. Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Arch Intern Med. 2008;168(13):1409–15.CrossRef
4.
go back to reference Administration on Aging, Administration for Community Living & U.S. Department of Health and Human Services. A profile of older Americans: 2014. Administration on Aging, Administration for Community Living & U.S. Department of Health and Human Services. A profile of older Americans: 2014.
5.
go back to reference Prohaska TR, Glasser M. Patients' views of family involvement in medical care decisions and encounters. Res Aging. 1996;18:52–69.CrossRef Prohaska TR, Glasser M. Patients' views of family involvement in medical care decisions and encounters. Res Aging. 1996;18:52–69.CrossRef
6.
go back to reference Schilling LM, Scatena L, Steiner JF, Albertson GA, Lin CT, Cyran L, et al. The third person in the room: frequency, role, and influence of companions during primary care medical encounters. J Fam Pract. 2002;51(8):685–90.PubMed Schilling LM, Scatena L, Steiner JF, Albertson GA, Lin CT, Cyran L, et al. The third person in the room: frequency, role, and influence of companions during primary care medical encounters. J Fam Pract. 2002;51(8):685–90.PubMed
7.
go back to reference Clayman ML, Roter D, Wissow LS, Bandeen-Roche K. Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. Soc Sci Med. 2005;60(7):1583–91.CrossRef Clayman ML, Roter D, Wissow LS, Bandeen-Roche K. Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. Soc Sci Med. 2005;60(7):1583–91.CrossRef
8.
go back to reference Ishikawa H, Roter DL, Yamazaki Y, Hashimoto H, Yano E. Patients' perceptions of visit companions' helpfulness during Japanese geriatric medical visits. Patient Educ Couns. 2006;61(1):80–6.CrossRef Ishikawa H, Roter DL, Yamazaki Y, Hashimoto H, Yano E. Patients' perceptions of visit companions' helpfulness during Japanese geriatric medical visits. Patient Educ Couns. 2006;61(1):80–6.CrossRef
9.
go back to reference Laidsaar-Powell RC, Butow PN, Bu S, Charles C, Gafni A, Lam WW, et al. Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations. Patient Educ Couns. 2013;91(1):3–13.CrossRef Laidsaar-Powell RC, Butow PN, Bu S, Charles C, Gafni A, Lam WW, et al. Physician-patient-companion communication and decision-making: a systematic review of triadic medical consultations. Patient Educ Couns. 2013;91(1):3–13.CrossRef
10.
go back to reference Brown JB, Brett P, Stewart M, Marshall JN. Roles and influence of people who accompany patients on visits to the doctor. Can Fam Physician. 1998;44:1644–50.PubMedPubMedCentral Brown JB, Brett P, Stewart M, Marshall JN. Roles and influence of people who accompany patients on visits to the doctor. Can Fam Physician. 1998;44:1644–50.PubMedPubMedCentral
11.
go back to reference Greene MG, Majerovitz SD, Adelman RD, Rizzo C. The effects of the presence of a third person on the physician-older patient medical interview. J Am Geriatr Soc. 1994;42(4):413–9.CrossRef Greene MG, Majerovitz SD, Adelman RD, Rizzo C. The effects of the presence of a third person on the physician-older patient medical interview. J Am Geriatr Soc. 1994;42(4):413–9.CrossRef
12.
go back to reference Wolff JL, Roter DL. Family presence in routine medical visits: a meta-analytical review. Soc Sci Med. 2011;72(6):823–31.CrossRef Wolff JL, Roter DL. Family presence in routine medical visits: a meta-analytical review. Soc Sci Med. 2011;72(6):823–31.CrossRef
13.
go back to reference Silliman RA. Caring for the frail older patient: the doctor-patient-family caregiver relationship. J Gen Intern Med. 1989;4(3):237–41.CrossRef Silliman RA. Caring for the frail older patient: the doctor-patient-family caregiver relationship. J Gen Intern Med. 1989;4(3):237–41.CrossRef
14.
go back to reference Beisecker AE. The influence of a companion on the doctor-elderly patient interaction. Health Commun. 1989;(1):55–70. Beisecker AE. The influence of a companion on the doctor-elderly patient interaction. Health Commun. 1989;(1):55–70.
15.
go back to reference Rosland AM, Piette JD, Choi H, Heisler M. Family and friend participation in primary care visits of patients with diabetes or heart failure: patient and physician determinants and experiences. Med Care. 2011;49(1):37–45.CrossRef Rosland AM, Piette JD, Choi H, Heisler M. Family and friend participation in primary care visits of patients with diabetes or heart failure: patient and physician determinants and experiences. Med Care. 2011;49(1):37–45.CrossRef
16.
go back to reference AHRQ, Agency for Healthcare Research and Quality. June 2014. Care coordination measures atlas update. AHRQ, Agency for Healthcare Research and Quality. June 2014. Care coordination measures atlas update.
17.
go back to reference Ward BW. Barriers to health care for adults with multiple chronic conditions: United States, 2012–2015. NCHS data brief, no 275. Hyattsville, MD: National Center for Health Statistics 2017. Ward BW. Barriers to health care for adults with multiple chronic conditions: United States, 2012–2015. NCHS data brief, no 275. Hyattsville, MD: National Center for Health Statistics 2017.
18.
go back to reference Lin CT, Albertson GA, Schilling LM, Cryan EM, Anderson SN, Ware L, et al. Is patients' perception of time spent with the physician a determinant of ambulatory patient satisfaction? Arch Intern Med. 2001;161(11):1437–42.CrossRef Lin CT, Albertson GA, Schilling LM, Cryan EM, Anderson SN, Ware L, et al. Is patients' perception of time spent with the physician a determinant of ambulatory patient satisfaction? Arch Intern Med. 2001;161(11):1437–42.CrossRef
19.
go back to reference Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: a systematic review. Br J Gen Pract. 2002;52(485):1012–20.PubMedPubMedCentral Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: a systematic review. Br J Gen Pract. 2002;52(485):1012–20.PubMedPubMedCentral
20.
go back to reference Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Medical Care Research and Review: MCRR. 2014;71(5):522–54.CrossRef Anhang Price R, Elliott MN, Zaslavsky AM, Hays RD, Lehrman WG, Rybowski L, et al. Examining the role of patient experience surveys in measuring health care quality. Medical Care Research and Review: MCRR. 2014;71(5):522–54.CrossRef
21.
go back to reference Wolff JL, Roter DL. Older adults' mental health function and patient-centered care: does the presence of a family companion help or hinder communication? J Gen Intern Med. 2012;27(6):661–8.CrossRef Wolff JL, Roter DL. Older adults' mental health function and patient-centered care: does the presence of a family companion help or hinder communication? J Gen Intern Med. 2012;27(6):661–8.CrossRef
22.
go back to reference Wolff JL, Boyd CM, Gitlin LN, Bruce ML, Roter DL. Going it together: persistence of older adults' accompaniment to physician visits by a family companion. J Am Geriatr Soc. 2012;60(1):106–12.CrossRef Wolff JL, Boyd CM, Gitlin LN, Bruce ML, Roter DL. Going it together: persistence of older adults' accompaniment to physician visits by a family companion. J Am Geriatr Soc. 2012;60(1):106–12.CrossRef
23.
go back to reference Gordon HS, Street RL Jr, Sharf BF, Souchek J. Racial differences in doctors' information-giving and patients' participation. Cancer. 2006;107(6):1313–20.CrossRef Gordon HS, Street RL Jr, Sharf BF, Souchek J. Racial differences in doctors' information-giving and patients' participation. Cancer. 2006;107(6):1313–20.CrossRef
24.
go back to reference Israel BA, Schulz AJ, Parker EA, Becker AB, Allen AJ III, Guzman JR. Critical issues in developing and following community-based participatory research principles. In: Minkler M, Wallerstein N, editors. Community-based participatory research for health. San Francisco: Jossey-Bass; 2003. p. 53–76. Israel BA, Schulz AJ, Parker EA, Becker AB, Allen AJ III, Guzman JR. Critical issues in developing and following community-based participatory research principles. In: Minkler M, Wallerstein N, editors. Community-based participatory research for health. San Francisco: Jossey-Bass; 2003. p. 53–76.
25.
go back to reference Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398–405.CrossRef Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398–405.CrossRef
26.
go back to reference Sim J. Collecting and analysing qualitative data: issues raised by the focus group. J Adv Nurs. 1998;28(2):345–52.CrossRef Sim J. Collecting and analysing qualitative data: issues raised by the focus group. J Adv Nurs. 1998;28(2):345–52.CrossRef
27.
go back to reference Mays N, Pope C. Qualitative research in health care. Assessing quality in qualitative research. BMJ. 2000;320(7226):50–2.CrossRef Mays N, Pope C. Qualitative research in health care. Assessing quality in qualitative research. BMJ. 2000;320(7226):50–2.CrossRef
28.
go back to reference Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320(7227):114–6.CrossRef Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320(7227):114–6.CrossRef
29.
go back to reference Crabtree B, Miller W. Using codes and code manuals: a template organizing style of interpretation. In: Crabtree BF, Miller WL, editors. Doing qualitative research (2nd ed.). Thousand Oaks, CA: Sage Publications; 1999. p. 163–77. Crabtree B, Miller W. Using codes and code manuals: a template organizing style of interpretation. In: Crabtree BF, Miller WL, editors. Doing qualitative research (2nd ed.). Thousand Oaks, CA: Sage Publications; 1999. p. 163–77.
30.
go back to reference Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. Second Edi ed: Sage Publications; 1994. Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. Second Edi ed: Sage Publications; 1994.
31.
go back to reference Omole FS, Sow CM, Fresh E, Babalola D, Strothers H. Interacting with patients' family members during the office visit. Am Fam Physician. 2011;84(7):780–4.PubMed Omole FS, Sow CM, Fresh E, Babalola D, Strothers H. Interacting with patients' family members during the office visit. Am Fam Physician. 2011;84(7):780–4.PubMed
32.
go back to reference Santomassino M, Costantini GD, McDermott M, Primiano D, Slyer JT, Singleton JK. A systematic review on the effectiveness of continuity of care and its role in patient satisfaction and decreased hospital readmissions in the adult patient receiving home care services. JBI Libr Syst Rev. 2012;10(21):1214–59.PubMed Santomassino M, Costantini GD, McDermott M, Primiano D, Slyer JT, Singleton JK. A systematic review on the effectiveness of continuity of care and its role in patient satisfaction and decreased hospital readmissions in the adult patient receiving home care services. JBI Libr Syst Rev. 2012;10(21):1214–59.PubMed
33.
go back to reference Connell CM, Gibson GD. Racial, ethnic, and cultural differences in dementia caregiving: review and analysis. Gerontologist. 1997;37(3):355–64.CrossRef Connell CM, Gibson GD. Racial, ethnic, and cultural differences in dementia caregiving: review and analysis. Gerontologist. 1997;37(3):355–64.CrossRef
34.
go back to reference Dilworth-Anderson P, Brummett BH, Goodwin P, Williams SW, Williams RB, Siegler IC. Effect of race on cultural justifications for caregiving. J Gerontol B Psychol Sci Soc Sci. 2005;60(5):S257–62.CrossRef Dilworth-Anderson P, Brummett BH, Goodwin P, Williams SW, Williams RB, Siegler IC. Effect of race on cultural justifications for caregiving. J Gerontol B Psychol Sci Soc Sci. 2005;60(5):S257–62.CrossRef
35.
go back to reference Pyke KD, Bengston VL. Caring more or less: individualistic and collectivist systems of family eldercare. J Marriage Fam. 1996;58:379–92.CrossRef Pyke KD, Bengston VL. Caring more or less: individualistic and collectivist systems of family eldercare. J Marriage Fam. 1996;58:379–92.CrossRef
36.
go back to reference Roth DL, Fredman L, Haley WE. Informal caregiving and its impact on health: a reappraisal from population-based studies. The Gerontologist. 2015;55(2):309–19.CrossRef Roth DL, Fredman L, Haley WE. Informal caregiving and its impact on health: a reappraisal from population-based studies. The Gerontologist. 2015;55(2):309–19.CrossRef
37.
go back to reference Ryan LH, Smith J, Antonucci TC, Jackson JS. Cohort differences in the availability of informal caregivers: are the boomers at risk? Gerontologist. 2012;52(2):177–88.CrossRef Ryan LH, Smith J, Antonucci TC, Jackson JS. Cohort differences in the availability of informal caregivers: are the boomers at risk? Gerontologist. 2012;52(2):177–88.CrossRef
Metadata
Title
Non-spouse companions accompanying older adults to medical visits: a qualitative analysis
Authors
Orla C. Sheehan
Anita L. Graham-Phillips
John D. Wilson
Deidra C. Crews
Cheryl L. Holt
Jennifer Gabbard
Katherine C. Smith
Jennifer L. Wolff
David L. Roth
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1098-y

Other articles of this Issue 1/2019

BMC Geriatrics 1/2019 Go to the issue