For doctors: working with older patients and their families, home visits, online consultations and communication

According to the World Health Organization, between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double from 12% to 22%. Working with older patients calls for a distinct approach because of multiple chronic conditions, polypharmacy, functional decline and families who share the burden of care. This article offers a practical framework for doctors who want to reach older patients and their families; it does not replace clinical guidelines.

Core areas of a comprehensive assessment

• Medication review: prescribed, over-the-counter and herbal products; deprescribing unnecessary or interacting drugs.
• Falls history and risk: balance, gait, orthostatic blood pressure, vision.
• Cognition and mood: memory complaints, depression, history of delirium.
• Activities of daily living: eating, bathing, dressing, toileting, managing medicines and money.
• Nutrition, weight change, swallowing, oral and dental health.
• Continence, sleep, pain.
• Social support: who they live with, who the carer is, the carer’s burden.
• The patient’s priorities and treatment goals; advance care preferences.

Communicating with the family and caregiver

A family member or caregiver is often present when an older patient is seen. Address the patient directly, involve them in decisions as far as possible and respect their consent when sharing information. Giving the family recommendations as a short written plan noticeably improves adherence: medication times, measurements to monitor, thresholds for “call me if…” and “call your local emergency number (112 in Türkiye and across the EU) if…”, and the next review date.

Home visit preparation checklist

• Ask the family beforehand to gather medicine boxes and recent test results.
• Agree the purpose, length and fee of the visit in advance.
• Use the opportunity to assess the home for fall risk, accessibility and care conditions.
• Spend a few minutes alone with the carer; their burden and observations are valuable information.
• Leave your recommendations in writing and agree how follow-up will happen (review, phone, online consultation).

Online consultations: where they work and where they fall short

Online consultations can work well for chronic disease follow-up, reviewing test results, medication adherence, carer education and involving family members who live far away. New complaints needing a physical examination, acute problems and marked changes call for a face-to-face assessment or referral to emergency services. Asking the family to prepare the camera angle, lighting, sound and measuring devices beforehand makes the session more productive. Keeping up with current telehealth regulations and data protection obligations is the doctor’s responsibility.

What families look for when choosing a doctor

• Experience and interest in older patients (e.g. dementia, heart failure, Parkinson’s, rehabilitation).
• Home visit and online consultation options, and the area covered.
• A clear, up-to-date availability calendar.
• Fees made clear in advance.
• Verified medical degree and specialty.
• Plain language and time for the family.

Joining WellFamily as a doctor

Registration, verification and listing on WellFamily are free for doctors. In your profile you set your specialty, the province you serve, your options for clinic appointments, home visits and online consultations, your fees and your available hours. Families can only request the slots you leave open, and the decision to accept is always yours. No commission is taken on appointments. Health data the patient has explicitly consented to share in the mobile app is visible to you for as long as consent lasts. You can also publish informative articles on our blog to bring your expertise to families.