Discuss patient-centered care An open, honest conversation with the older adult patient about patient-centered care and how health care has evolved is an important part of care.  Access to medical information through technology has expanded, providing patients with myriad resources that while helpful, may be confusing.6 In addition, older adult patients may be more reticent to challenge their doctor’s opinions or even ask appropriate questions for clarification about health issues. With all of this in mind, they may refrain from asking key questions about their care, or feel confused about where to access important health information. As health professionals, we can encourage and assist them to become self-advocates in this capacity. Also important, the interdisciplinary team should to work together to discuss the older adult patient’s specific needs regarding health literacy to assist them with this process.

Resources for clinicians

Health literacy action: Toolkit for patient educators
(Cancer Patient Education Network)

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American Cancer Society

Improving Health Literacy for Older Adults
(Centers for Disease Control and Prevention)


Improving Health Literacy: Training Resources: Welcome
(University of Michigan Library)

Doctor-Patient Communication

Use plain language Plain language is communication that users can understand the first time they read or hear it. Key elements of plain language include

  • Organizing information so that the most important points come first,
  • Breaking complex information into understandable chunks,
  • Using simple language and defining technical terms.7

Assess, acknowledge, and utilize strengths The older adult patient has numerous strengths that can assist them in improving health literacy. An important aspect of care is to work with older adults to assess strengths and provide feedback regarding strengths and self-care. 

Foster independence Maintaining independence is an incredibly important part of aging. Aging brings many changes that can include loss of independence due to physical, cognitive, and social changes. Provide appropriate tools and resources to older adult patients, and allow them to use these to manage their care.


Numerous tools are available to assist patients with improving health literacy. Some helpful tools are a glossary of medical terms; a personal health journal that includes a medication list, symptoms log, section to write questions and concerns to discuss with health care provider, and important numbers related to their care; and creating a personal health record (PHR) that keeps medical information in one place.

Sarah Kelly is an oncology social worker and coordinator for Older Adult Services at CancerCare.


1. Kutner M, Greenberg E, Jin Y, Paulsen C. The Health Literacy of Americas Adults: Results From the 2003 National Assessment of Adult Literacy. Washington, DC: US Department of Education, National Center for Education Statistics; 2006. NCES 2006-483.

2. US Department of Health and Human Services. Health Literacy Interventions and Outcomes: An Updated Systematic Review [structured abstract]. Rockville, MD: Agency for Healthcare Research and Quality, US Department of Health and Human Services; 2011. AHRQ Publication No. 11-E006. http://www.ncbi.nlm.nih.gov/books/NBK82434/ . Accessed September 10, 2015.

3. US Department of Health and Human Services. Health communication. In: US Department of Health and Human Services. Healthy People 2010. Washington, DC: US Government Printing Office; 2000. http://www.healthypeople.gov/2010/Document/HTML/Volume1/11HealthCom.htm. Accessed September 10, 2015.

4. Cornett S. The effects of aging on health literacy. http://medicine.osu.edu/sitetool/sites/pdfs/ahecpublic/HL_Module_Elderly.pdf. Accessed September 11, 2015.

5. American Psychiatric Association. What mental health providers should know about working with older adults. American Psychological Association Web site. http://www.apa.org/pi/aging/resources/guides/practitioners-should-know.aspx. Accessed September 11, 2015.

6. Centers for Disease Control and Prevention, US Department of Health and Human Services. Improving Health Literacy of Older Adults: Expert Panel Report 2009. Atlanta, GA: US Department of Health and Human Services; 2009. http://www.cdc.gov/healthliteracy/pdf/olderadults.pdf. Accessed September 11, 2015.

7. Office of Disease Prevention, US Department of Health and Human Services. Plain Language: A Promising Strategy for Clearly Communicating Health Information and Improving Health Literacy. Rockville, MD: US Department of Health and Human Services. http://www.health.gov/communication/literacy/plainlanguage/IssueBrief.pdf. Accessed September 11, 2015.