The ability to understand and use the information about our health conditions is one of the most important self-care skills we can have. Yet a report from the U.S. Department of Health and Human Services reveals that almost 9 out 10 adults find it difficult to use health information found in clinics, retailers, media and the community. At least 90 million Americans face some difficulty understanding and acting on information they receive about health care.
Programs like Living Well, Health Living with Diabetes and Stepping On help older adults take charge of getting - and acting on - the information they need to improve their health. As workshop participants develop action plans and practice new communication skills, they gain confidence to ask questions of health providers- even when it feels uncomfortable. And asking questions is key for older adults who have chronic conditions or are caregivers.
"I think of the doctor, about to leave, with his hand on the doorknob saying 'Any questions?'" says health literacy advocate Steve Sparks. "Don't give up!" Sparks advises. "The best time to get the information you need is before you leave the doctor's office."
Sparks's organization - Wisconsin Health Literacy - is part of a growing national effort to make health care information - from office visits to medication labels - easier for patients to grasp and put into practice. "We all prefer clear communication," Sparks points out. The impact of better health instructions can be dramatic, according to Sparks. "Research shows plain language health instructions lead to fewer hospitalizations, ED readmissions, and fewer adverse drug events for patients with chronic illnesses like heart failure and diabetes."
"Almost everyone will have a problem at some point understanding what they need to know about a health condition or using medication," Sparks says. However, the need to improve communication with older people is especially urgent. "Normal cognitive changes that come with aging can affect people's ability to understand and use health information," Sparks says. Changes in vision and hearing, as well as medication side-effects, are other challenges for older adults. Nationally, just 3% of adults over 65 have "proficient" health literacy skills, compared with about 12% of all adults - still a shockingly low measure.
"When I recently spoke to an aging services group, they were genuinely surprised to hear the scope of the problem. In reality, better health literacy is a shared responsibility," comments Sparks, "but there is much more that providers can do to improve how they communicate with older adults."
Prescription labels are one area where Wisconsin Health Literacy is taking a national leadership role. New federal guidelines for better prescription labels would especially benefit older adults, who often take multiple medications. However, the guidelines are voluntary - and very few states have made the switch.
"We already know that easier to read labels make a difference for people, and lead to better health outcomes," Sparks confirms. "Wisconsin Health Literacy is now working with UW Health and Hometown Pharmacies to develop a model for successfully transitioning to the new label. By identifying how that process can work more smoothly, we hope more states will adopt the guidelines - and help consumers get better health care."
Asking questions is key - even if it feels uncomfortable. Sparks says older adults with low health literacy are less likely to ask questions because they may feel ashamed or afraid to ask to have information repeated. He recommends these ideas for improving your health literacy:
1) Prepare carefully for your healthcare visits. Know ALL:
2) Use the Ask3 framework for your questions:
3) DON'T GIVE UP if you still don't understand!